Tuesday, September 25, 2007

NP STANDS FOR "NO PLEASE"

My wife recently took my 18 month old to a pediatric neurologist that was recommended by our pediatrician. I like our pediatrician. She’s very direct and “old school” and is highly competent. So I trust a recommendation from her.

She may be right, and this pediatric neurologist may be great. However, I would never know because my wife told me that she NEVER EVEN GOT TO SEE HIM!!! No, she saw the Nurse Practitioner (cue scary music). And then when my wife protested, the staff told her “Oh, don’t worry. The doctor will come in to see your child afterward”.

Well, that turned out to be a gigantic load of bird-plop! He wasn’t EVEN IN THE OFFICE!!!

I called the doctor himself to protest this shoddy treatment. He reassured me that his NP was his “partner” for six years, that the NP had published more papers than the doctor had, that the NP’s capabilities were superb.

I told him that, while all of this may be true, there was one indisputable fact: I know what kind of training (for the most part) a pediatric neurologist has received. I have NO FREAKING IDEA what kind of training a pediatric neurology NP has received. And what’s more, I really don’t care! I don’t care if the NP has written 100 papers, published in every major journal in the nation (well, actually that would be pretty cool).

Also, I object to his use of the word “partner”, as if his credentials were somehow equivalent with the NP’s. What is he thinking?

Look, I understand why NP’s exist. It’s an economic reality of office based practice. It increases the number of patients that can be seen. However, when it comes to a very specialized group of patients, especially nervous parents who obsess about their little one, for whom they’ve lost so much sleep (SO MUCH) in the last 18 months, I think an NP is not good enough. And shame on his staff for lying about his availability. (He states he was stuck at another hospital, which I understand. But the staff completely misled my wife).

I will never employ an NP to see my patients for me. End of story. Ditto for PA’s. They can draw blood, they can do post visit counseling, they can hold a patient’s hand.

But they aren’t doctors.

146 comments:

Chrysalis Angel said...

I completely agree with you on this. I have had the bait and switch and didn't know it, until I was on the table and in a gown. I would never trust an office that had mislead me in the way your wife was.

Anonymous said...

You are ignorant, many Pas and NPs are very educated and experienced, and majority of the time know more medicine than the doctors who emply them.. I agree that the deceit by the doctor your wife wanted to see, would also anger me...but open your mind...

Anonymous said...

THERE ARE MANY OUTSTANDING PAs AND NPs, HOWEVER YOUR POINT IS WEEL TAKEN. IF I OR MY SPOUSE OR CHILDREN GO TO A SPECIALIST THEN WE ARE PAYING FOR A SPECIALIST! NO WAY A PA OR NPs TRAINING IS EQUAL TO A MEDICAL DEGREE AND RESIDENCY, I DON'T CARE HOW MANY YEARS EXPERIENCE SAID PA/NP HAS. I WONDER HOW HONEST/ETHICAL IT IS TO BILL FOR THE EXPERIENCE OF A SPECIALIST WHEN THAT SPECIALIST HAS NOT EVEN SEEN THE PATIENT? I HAVE NEVER HEARD OF A DISCOUNT FOR SEEING A PA/NP.

Anonymous said...

Amen.

As a Pharmacist I can say that I get more scary prescriptions from mid level practitioners. I wouldnt trust one to treat an ingrown toenail let alone something that requires the kind of expertise you were seeking.

Anonymous said...

You all seem very closed-minded on these issues that are reflective of the inevitable medical trends of our country. I myself am an advanced practice psychiatric nurse. I specialize in psychiatric conditions. My scope of practice given to me by accrediting bodies is also outlined within a collaborative practice agreement with a psychiatrist who is available and supervises the service and care that I provide. If there are certain conditions that I feel I am not knowledgeable enough to treat in a competent, prudent manner, I consult with the doctor to assist me in providing the level of care needed by my patient. But, my experience and 5 years of post-graduate education has allowed me to effectively treat conditions that other doctors might find difficult to treat (and do) as I work in an underserved area that is depleted of practitioners. Additionally, if you peruse the multiple studies that compare the level of patient satisfaction with services provided by advanced practice nurses as compared to medical doctors, I think you might even consider seeking the services of an APRN so that you can see for yourself. I am in no way discounting the vast amounts of knowledge an MD has, compared to my understanding which is limited to psychiatry. But,depression is depression and psychosis is psychosis. And advanced practice nurses have specialized in the fields of their practice and are well able to treat such conditions, or they wouldn't be trusted by those who credential them while continuing to further their level of prescriptive authority and autonomy.
Please, become educated about such issues before casting stones at some of the most passionate and dedicated professionals who have fought so hard to serve the patients who are in need of good medical services. These are not phlebotomists or hand-holders. These are trained, well-educated professionals.
And, as far as the pharmacist that commented earlier, I have seen prescriptions by MD specialists that have made my head spin. So, please, do not generalize based on what is most likely your limited experience with who was most likely an inexperienced mid-level prescriber.

amanda said...

I agree you should not have not been told you were seeing a specialist when you would not be doing such a thing, but maybe you should actually research before you bash?

Anonymous said...

Shouldn't at least the initial patient evaluation be done by the specialist then the follow up visit possibly be done by the NP or the PA. I know other health professionals function that way, such as a patient is prescribed physical therapy, the PT does the initial eval, to decide on plan of care and treatment, then follow up visits performed by the PTA, and reports back to the PT on progress and concerns. By the way dude chill out, have a beer or something you seem way to stressed out to function on a daily basis.

Anonymous said...

You are fooling yourself to think a NP has more knowledge than a physician. Until a NP completes medical school, a residency, and a fellowship, they will never realize how much they don't know yet. As a physician, I cannot imagine how I could have effectively cared for patients without have been through residency.

Anonymous said...

You are right in most respects here. I currently work in retail pharmacy near a couple clinics that pump out huge amounts of volume simply due to the large number of PA's they employ. To them medicine is simply a business so when they fuck up I have to look like the bad guy for telling a patient with stage 1 hypertension that I cannot fill their prescription for Enalapril 80mg BID because the PA was an idiot. THEN, all while the patient is pissed off at me for ever accusing "Dr. John Doe" (yes this PA thought it less confusing for the patients if they thought he was a Dr.) of making a mistake. I call the office and speak with the PA only to get yelled at by him asking me how dare I ever question his practicing..........
Don't get me wrong, there are many many many great PA's and NP's out there and its a shame that they get overlooked due to the massive amounts of assholes who get cocky due to the fact they can write a prescription (though they forget its supposed to be under a PHYSICIAN'S protocol), but I just get tired of seeing prescriptions that are horribly wrong. Especially when its a child's medications, there is just no excuse for that and I see it all the time.

Anonymous said...

I came upon this inadvertantly. I guess I never realized how threatened some people may be by the growing numbers of Nurse Practitioners and Physician Assistants. I can understand the desire to see the MD specialist, however, would it have been better for the office to say, let you reschedule to a later date for evaluation, than try to accomadate you with another provider to get the ball rolling?
Also I must say the term "mid level" is actually quite an insult. I am a NP, I work in a specialty surgery group. I do not believe any of the NP's or PA's in my group provide "mid level care"
As for not hiring an NP or PA, that is your choice, and I am sure that the growing numbers appreciate not working for someone who is obviously unable to function in a team atmosphere. I do however think that the MD's who are as arrogant as yourself should know that MD means Medical Doctor, it is not the same spelling as GOD. MD's make mistakes, errors, and also have to review thier pharmacology time to time. I think that it is disappointing that you behaved in such a way that you felt that you were so much more important than anyone else, and that the office that attempted to accomodate your wife, was not apprieciated. I am sure the NP discusses all of her cases with the specialist, usually that is how it works. It is called "collaboration". There is a definition in Websters, but considering you are so knowledgable regarding practice I am sure you know this.
By the way, are you by any chance a proctologist, because I am sure you would do quite well in that area, since you speak that language.
As for the pharmacists who commented, shame on you. You should be willing to work with all providers, if I came across you, I would recommend my patients find someone who understands that from MD, NP, PA, RN... are supposed to be working together to achieve the best possible care for people, including yourselves.. I love to call my pharmacist and ask for recommendations, I am glad I have not found one like you.

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Megan E. said...

As another unfortunate person commented, I came upon this article by accident. As part of my education as a Nurse Practitioner, we were assigned to write a paper comparing the differences between healthcare providers (MD, DO, PA, NP). I refuse to let your close-minded bigoted views persuade my opinion of physicians, as I hope others reading this will not have a misconstrued idea of Nurse Practitioners. Perhaps it's insecurities or just stupidity, but before you begin insulting a large population of people, please have a little more respect for yourself. I feel sorry for your patients and the staff that is forced to work with such a hostile person. I do not feel the need to justify or explain to you my creditials as a Nurse Practitioner, nor do I give much credit to your views. Perhaps you should have another conversation with the pediatric neurologist you were recommended to see, as he obviously has much more common sense that you.

Anonymous said...

I am a medical student. I was given a prescription at the student health center AT MY MEDICAL SCHOOL by an NP, over the phone. Of course I checked it. It seemed wrong (not even the right category of drug). I called back. They checked, they called back and said it was correct. I TOOK THE WRONG DRUG FOR 2 DAYS. Kept researching. It was completely the wrong drug!! Given that I had a known diagnosis, the prescription was cut and dried. So why did I and others at the school have experiences like this?? I actually think a PA would probably do better, they work more with doctors and work under a doctor. The NPs here don't even know what they don't know!!

Anonymous said...

First hope your little one is ok. Then not to agree on some of your opinion. Sooner or later NP will need a Doctoral degree instead of the current Masters,including many more clinical hours (eq. to residency in Doctor's). NPs are getting approx. same amount of education as the Doctors. Many Doctors in the U.S. are ignorant and misleading, not to say the Nurses and PAs. It just depends on the person. Do not strike a career just b/c you are mad at a particular NP. Just NOT right.

Anonymous said...

ok you are all talking about how NPs are paid the same and its a scam, you are so stupid. NPs get paid 60-80% less by insurance companies compared to primary care physicians. They make less and you don't pay the same. You people need to get your head out of your ass before you talk and shit you don't know. You people make me sick how stupid you are. NPs are also regularly is 6 years of schooling. They are treated in all the same course as doctors with the exception of surgery and niche diseases. They know all the same medicine as doctors and they know most the same skills.
I feel safe being an authority on this because i am a doctor and my wife is a NP. I couldn't be more proud to call her my partner.

Anonymous said...

What really gets me is that people feel that NPs are "less educated" than MDs, Most NPs are trained under MDs just as PAs are. Yes, some may not be that great, but that is the same for MDs as well. I just had a question, did the NP do something that jeopardized the patient, I never saw a comment as to whether or not the child benefited from the consultation. Just that you were upset that your wife did not see the MD. I agree, that you should not have been deceived by the staff, but to hold the NP accountable for that is just ridiculous.
Besides, NPs can not make less than a B average to continue in school, but if an MD makes a C, he is still considered a Doctor... just something to think about.

Anonymous said...

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Anonymous said...

Unreal that we are in 2011 and you people are so ignorant. Nurses, in many hospital and office settings make many important decisions for their patients and you as a patient may not even know it. Nurses are an advocate for you, the ignorant patient, take all your crap and yet we are still the ones who feel for you after all you say about us. The doctor would not hire a Nurse Practitioner to see their patients if they did not trust them. Many nurse practitioners have seen more in the hospital than many doctors as the doctors are only there for what, 3 minutes while the nurse sees what goes on, many times, for 36 to 48 hours a week. The nurse assesses what is wrong with the patient and many times will order testing or treatment before speaking to the MD because they are aware of what is wrong and what needs done. As for the Pharmacist on here, what a crock. I work with many mindless Pharmacists who screw shit up and also, I will call them with a question and they look it up on a computer, like I, the "worthless" NP couldnt have done that myself. Deal with it. NPs will become more and more common as medical students will not go into family practice because none of them care about the patient enough to go into family practice, the money isnt good enough, so they will go into a specialy... Then they will still be overwhelmed and hire us anyways... Good Luck and Open you mind!!!

4tuneteller said...

I agree that patients should never be misled about the qualifications of the clinician who is seeing them. Likewise, physicians should not use the title "Dr." in an attempt to lend credibility to a purely emotional opinion. Obviously our friend, the Dr., is quite emotional about his child's healthcare and understandably so.(The child was taken to the doctor by the wife but 21st century social constructs leave the writer's gender ambiguous. There is ample reason not to assume the writer is a man. However, for the sake of limiting argument, I will refer to the writer as a male.) He is so emotional, in fact, that he abandons all scientific reasoning. By his own admission he does not have all the facts and does not CARE to have the facts. He doesn’t need facts because he is not presenting a fact-based viewpoint. He’s presenting a parental reaction.
All parents are entitled to react -- even doctors. But just as Nurse Practitioners shouldn't attempt to pass themselves off as doctors, the opinion of an hysterical parent should not be given more credibility simply because it is advanced by someone who has the ABILITY to draw conclusions based on scientific evidence. The doctor tells us that he doesn't know or care about the facts regarding a Nurse Practitioner's education. He doesn't offer a single shred of evidence about patient outcomes when treated by Nurse Practitioners rather than physicians. Physician, of course, is a broad term that in this example could mean either a medical doctor or an osteopathic physician. Further, this parent does not distinguish between a poor-performing osteopathic resident who just finished his residency and plopped a sign on his door a few days ago and a renowned medical doctor with years of clinical experience. Either, apparently, is superior to a veteran RN with thirty years of clinical experience in neurology who is a Certified Neurological Nurse Practitioner with a Doctoral degree in Nursing Practice. Even a lay person can see the problem with this conclusion. "Doctors" in any field are trained to employ critical analysis of the evidence as a basis for establishing a scientific opinion. In fact, no respectable medical journal would publish the work of a "doctor" who could not support his opinions with peer-reviewed evidence. Thank goodness we don’t open the annals of medicine to find the unsupported opinions of an emotional parent being passed off as the intellectual work of an educated physician. There are reasons for that. And there are reasons why this Doctor’s paternal opinions are on an internet blog rather than in a scientific journal. The argument used by physicians to insist that doctorally prepared Nurse Practitioners don’t use the title “Doctor” is that it might “confuse” patients. Because DNP’s might wear white coats, diagnose disease, prescribe medication, admit to the hospital, etc. a patient might mistakenly believe they are medical doctors simply because they are using the title “Doctor.” I know this is going to surprise someone, but I can see their point. At the same time, readers might be confused and mistakenly believe that an emotional parent is advancing scientific viewpoints simply because he uses the title “Doctor.” Let’s not let the pot get away with calling the kettle black.

4tuneteller said...

I agree that patients should never be misled about the qualifications of the clinician who is seeing them. Likewise, physicians should not use the title "Dr." in an attempt to lend credibility to a purely emotional opinion. Obviously our friend, the Dr., is quite emotional about his child's healthcare and understandably so.(The child was taken to the doctor by the wife but 21st century social constructs leave the writer's gender ambiguous. There is ample reason not to assume the writer is a man. However, for the sake of limiting argument, I will refer to the writer as a male.) He is so emotional, in fact, that he abandons all scientific reasoning. By his own admission he does not have all the facts and does not CARE to have the facts. He doesn’t need facts because he is not presenting a fact-based viewpoint. He’s presenting a parental reaction.
All parents are entitled to react -- even doctors. But just as Nurse Practitioners shouldn't attempt to pass themselves off as doctors, the opinion of an hysterical parent should not be given more credibility simply because it is advanced by someone who has the ABILITY to draw conclusions based on scientific evidence. The doctor tells us that he doesn't know or care about the facts regarding a Nurse Practitioner's education. He doesn't offer a single shred of evidence about patient outcomes when treated by Nurse Practitioners rather than physicians. Physician, of course, is a broad term that in this example could mean either a medical doctor or an osteopathic physician. Further, this parent does not distinguish between a poor-performing osteopathic resident who just finished his residency and plopped a sign on his door a few days ago and a renowned medical doctor with years of clinical experience. Either, apparently, is superior to a veteran RN with thirty years of clinical experience in neurology who is a Certified Neurological Nurse Practitioner with a Doctoral degree in Nursing Practice. Even a lay person can see the problem with this conclusion. "Doctors" in any field are trained to employ critical analysis of the evidence as a basis for establishing a scientific opinion. In fact, no respectable medical journal would publish the work of a "doctor" who could not support his opinions with peer-reviewed evidence. Thank goodness we don’t open the annals of medicine to find the unsupported opinions of an emotional parent being passed off as the intellectual work of an educated physician. There are reasons for that. And there are reasons why this Doctor’s paternal opinions are on an internet blog rather than in a scientific journal. The argument used by physicians to insist that doctorally prepared Nurse Practitioners don’t use the title “Doctor” is that it might “confuse” patients. Because DNP’s might wear white coats, diagnose disease, prescribe medication, admit to the hospital, etc. a patient might mistakenly believe they are medical doctors simply because they are using the title “Doctor.” I know this is going to surprise someone, but I can see their point. At the same time, readers might be confused and mistakenly believe that an emotional parent is advancing scientific viewpoints simply because he uses the title “Doctor.” Let’s not let the pot get away with calling the kettle black.

4tuneteller said...

As for the student doctor who presents as evidence the fact that ONE NP write ONE erroneous prescription....what is your point? If I say an MD once wrote me an erroneous prescription, does that constitute evidence that MD's are inferior to DO's? No, but he wants us to draw a parallel conclusion based on a single observation. Even the pharmacist that claims to see a pattern of erroneous prescriptions written by NP's presents no credible evidence as to the conclusions that can be drawn. And what is the sample size? Two NP's in a community of 10,000? 250 in a community of a million? Provide some credible evidence worthy of debate.

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Anonymous said...

I'm not sure whether I'm more enlightened or disturbed by this blog. For starters, I just want to warn "The Angry Doctor" that this was one of the first things that came up when I googled "NP." As an undergraduate student at a large state university in the midwest, I am exploring different options for post graduation. I thought a lot about medicine, but I realized that my image was influenced by how our society and culture depicts doctors, not the actual reality. I realized that patient care is my interest, rather than medical science. Nurses work with patients, doctors assess case by case. The two with many other clinicians form a team. I recently completed my CNA, and I hated changing diapers. Stool and other horrible smells really bother me. That's why I'm only interested in a graduate entry nursing program, so I can be a clinical leader, rather than a bed-pan changer. I think this field really needs to be made more public, because its statements like this on google that inform most people unwilling to read a long blog. I think for me becoming a NP would be a perfect goal. I could have a doctorate and work in a practice after I work in clinics as an MSN. I have no interest in traditional medical education, it's just not me. Just like "nursing school" isn't for all MD's or DO's.

Angry Doc, I really hope your kid's okay, and it sounds like the office management was pretty poor. But to degrade the institution of Nurse Practitioners just cements my decision not to enter medicine. It seems like NPs join nursing for the right decisions, unlike some physicians who want the title and the money. If I earn a doctorate, I will introduce myself as doctor, but I will never omit my clinical role. Hi, I'm Dr. Steve Smith, a Nurse Practitioner, but you can call me Steve.

I want to become an NP. It's not because I'm not smart or dedicated enough to become an MD. You're just a really hostile doc, and I hope I never have to encounter burnouts like you.

Anonymous said...

You are an idiot, NP's have a lot of traning, they go to school for 6 - 8 years. If they weren't competant they wouldn't be employed. Anyone who disagrees needs to expand their education on the subject before giving their opinion. NP's know more about the patient than the actual MD!!!

Anonymous said...

You are an Intern not a Doctor... Didn't you just bitch about people calling themselves Dr. without actually being one??? Shut up! One day a NP or nurse will be saving your ass!!

Anonymous said...

To the "medical student" who took the wrong drug for 2 days, u are a total idiot! If u had any doubts, u should not have taken the drug! I'd hate to see u when u become a physician...that's the price u pay when u see the nurse practitioner in the caribbean where u're in medical school....

Sweet Discord said...

NP's do 7-9 years of training, much like physician. Perhaps instead of judging a book by it's cover you should do your research. I understand it is your child, but it is parents like you that are why I will never go into pediatrics.

Sweet Discord said...

NP's do 7-9 years of training, much like physician. Perhaps instead of judging a book by it's cover you should do your research. I understand it is your child, but it is parents like you that are why I will never go into pediatrics.

Anonymous said...

my husband crashed and coded following valve replacement surgery. we were not told that no doctors are part of the cicu staff. the np delayed treatment by ignoring his symptoms of falling bp and falling heart rate. nps have read the cookbook, but believe they are the chef.

Tremors said...

Amen to Anonymous-

Anonymous said...

HAHA @ your ability to not hire a NP, as if we didn't have enough positions that are available, champ.

Anonymous said...

Wow i have never read such blatant idiocy. I just goes to show you. Just about anyone can make pass med school.

Anonymous said...

Sad to see physicians think like this. I feel so fortunate working where I do. I'm an NP at probably the most prestigious hospital in the country. We have some of the highest patient outcomes for trauma and emergency medicine and I ( an NP ) do the majority of the training for the new medical residents the come to the program. The surgeons have full confidence of my abilities. So the questions is... if NP's are good enough to be at one of the most prestigious hospital in the country with some the best patient outcomes and the NP is allowed to train the MD/DO's the question is why are you so close minded. My fellow physicians would say they rely on me as much as I rely on them. They look at me as an equal.. not a physician extender or a midlevel.

Times are changing... thankfully for the better

Dr.AJ-DNP

pathrecords said...

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Anonymous said...

I agree that to provide the best care possible to the patient, we all must work as a team, We all need to know our roles and limitations,
the patients need to be clear on the fact that you are the "Nurse Practitioner", and they can choose to see you if they please, But too often I have seen NP introduce themselves as "doctors" without the Doctorate degree,
Misleadiing to say the least,
when a company hires 2 engineers to work on a project, they expect two Licensed engineers to be working on the project, Not an IT person, or a person who is "good " at what they do, but that is not what was paid for,
As any patient, has the right to know from the start of the visit, "RN, NP, PA, MD, DO" , not find out later on
if you are proud to be an NP, say it and present it to your patient, let them decide,
If you want to be call "Doctor", then get a doctorate, or Medical Degree,
Clearly Nurse Practitioners are trained to work with doctors, but are not trained to work solo,
I can tell you training to be a NP and then going back to get my MD and residency, were Two totally different ball games,
I thought I knew things, but did not have a good understanding of all the things I didn't know,
Not saying you are always going to know more as an MD, but the odds are that you have been put through more and had more hands on experiences in those equivalent number of years, (of course I am not comparing a NP with 30 years experience with a MD with 1 year experience)
Sometimes we think we know a lot, until we realize what we don't know, and that's why there are Medical School and Residency training to help us to have a better understanding of Do No Harm and Risk vs Benefits,
I respect both NP and MDs, but having experienced in both, I can say that 1 year of NP school is in NO way equivalent to 1 year of medical school/ residency, the depth of understanding and volume of information is drastically different, not including the responibilities and challenges faced during residency
I am proud of my background,as a NP, but until you go through both, you won't understand what I am referring to, ask any Doctors out there that were NP's, I highly doubt anyone of them will disagree with me,
I would be interested to know,


Best wishes, We should not forget our mission as health care providers, To help, To Heal, To comfort,
Together as a team,

Dr. Taghiei said...

You are a bitter old school doctor, that has a huge ego. Maybe if you deflated your head a bit you might enjoy life a little more...for sure people around you would enjoy you more. Until you're can let go of your enitlement because youre a "doctor" you should change your blog name to The Egotistical Doctor.

Anonymous said...

Get over yourself! Clearly, you feel threatened. NPs and PAs are highly educated healthcare professionals who are required to pass board certification. Certainly, if one is told that they will be seen by the MD, then they should be seen by the MD. I do not agree with the type of deception that occurred in this case, if in fact your story is even true. However, for you to belittle NPs and PAs only indicates your ignorance! Many national surveys, which are continually conducted, clearly indicate that patients are equally satisfied with the care that an NP or PA provides versus the MD. Certainly, we expect NPs and PAs to practice medicine within their scope of practice and to be upfront with regard to their limitations; however, don't be an ass and demean the quality care that NPs and PAs provide. Moreover, NPs and PAs provide cost-effective care. If MDs (MD = More Doe) were not so greedy and did not demand more and more money, then we would not need to be so concerned about cost in healthcare! In any case, NPs and PAs are here to stay, pal, and they will only become more and more in demand…deal with it!

Kent Kwan said...
This comment has been removed by the author.
Anonymous said...

I'm an MD who went through 4 years of medical school, 4 years of residency in order to practice emergency medicine. I out competed those who didn't get into medical school and didn't get into residency. I would say, you get what you paid for. NP/PA are not doctors, not even close. Sure people say they can handle 90% of the cases and doctors are only needed in the 10%. But think about this, they are not even trained enough to recognize what they cannot handle. That 10% will still get missed because they will not recognize that 10% and send them home! That means they will kill 10% of people. I'm an EM doc. 90% of patients I see get better if you just send them home without intervention. 10% needs some work and 1% needs your help or they die. I doubt PA/NP can recognize that 1% that truly needs my help. No, NP/PA are not doctors. Answer me this, any NP/PA if you are so qualified, would you let another NP/PA operate on your child without the surgeon in the room? Or if you are as well trained as physicians, why don't we just eliminate doctors all together and have you run the hospitals? Why have doctors over see you? Because hospitals try to be politically correct and save money, they put out this lie that NP/PA are just as good, but doctors still run the show because hospitals are not stupid.

Kent Kwan said...
This comment has been removed by the author.
Anonymous said...

I can understand your anger as it was not right what the office did. Always tell the truth as it always can come back with a worse bite. First of all, I hope your child is thriving!! I have been in Critical Care for many years. The Hospitalists, for the most part are great. When the doctor, ie surgeon or specialist, enters the unit, he can barely remember his patients name let alone the condition. Thank goodness for the nurse and Hospitalist's, who work in close proximity to care for the patient. Please do not judge a book by its cover. As a dad, and you will find out if not already known, there are always 2 sides to every story. In reality, there are incompetent nurses, doctors, PA's and NP's. Also, lawyers, pilots and mechanics. You have to weed out the bad ones. You must ask questions to become informed. Thank you!

Anonymous said...

I once took my daughter to a well known Children's hospital's ED. She had fever and flank pain. I requested a scan and was told it was unnecessary. She was sent home on a short course of antibiotics, only to end up in hospital later for several days. She was seen only my a physician. Does that mean I criticize all physicians and never see another one? Intelligent thinking will make allow me to even see the same physician again. Things happen. As for pharmacists piping up with their opinion, when you dispense the incorrect medications to children, who exposes you?

Physicians, please be careful about mindless dribble. The bedside RN may expose your flaws and stop covering your mistakes.

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I am dealing with this now. I was reffered to spinal clinic for serious back issues. I was told I would first see a NP who would give me information and then would see the doctor. When my next visit was scheduled, it was, again, with the NP. I called later to ask when I would see the doctor. I was not pleased with the NP> She did not explain things and seemed irritated with my questions. I was told that the doctors in the clinic do not actually see patients, except for special procedures. They come in and do the procedure and then leave. I'm appalled! I will find another facility!

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A doctor completes 4 years of college, 4 years of medical school, 3 years of residency then 2-3 years of fellowship e.g. cardiology, gastro...

In these years the doctors aren't working 40 hour weeks like the nurses, they are working 80 hour weeks...so not only is their education longer, but their clinical experience and exposure is almost double...

Another point, a nurse practitioner isn't really nursing anymore, they are practising medicine...the history, diagnosis and differential, investigations and treatment is a medical model not a nursing one. So of these years of training, only the graduate program really should count.
By that logic we could also discount the college training from the doctor I suppose, but even then its 2 years post graduate training for the nurse.
4 years of medical school, 3 years of resideny and 3 years of fellowship...so come on, to say that a nurse practitioner and a doctor are equivalent is ridiculous.

NPs/PAs are physician extenders to work under and support but never replace the physician, why do you NP have such a problem with this? If you want to be a doctor and practice medicine, go to medical school. But this nonsense of "equivalence" with a fraction of training and none of the exams physicians sit is it any wonder we as doctors get pissy?

I couldn't do a nurses roles without training as a nurse, who do nurses always feel they can do the doctors job just as well with a fraction of training? (Until it all goes wrong...then they call the doctor).

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Anonymous said...

Get over yourself. For goodness sake you are an internist.

Anonymous said...

Quit being reasonable. No one wants to know about those studies that show high NP patient satisfaction scores. Get with it. This is about anger and hate.

Anonymous said...

I would never see an MD over an NP for any sort of primary care (family medicine, internal medicine, etc.). For NPs, primary care is the pinnacle of the profession. For MDs, they are the bottom of the barrel in their med school class.

Anonymous said...

That's awesome for you. But what about the guy who barely graduated high school and just got his PA degree from the 2 year program at Riverside County Community College.

No thanks.

Anonymous said...

Go fuck yourself, cock

Anonymous said...

Lol the angry doctor... More like the retarded doctor. This Doc just mad cause he knows PAs and NPs who make more than he does, are younger than him, do a better job than he does and have made better life choices than he has. He probably didn't get the residency he initially wanted and is angry cause he grew up bad at a bunch of stuff except school. Then realized he wasn't good enough at that cause he got a low stage test score. Lmao so funny.

Listen I'm sorry your wife had a bad experience with an NP and you don't respect PAs or NPs. You should be smart enough to know though that there are even bad doctors too. Then again you probably don't cause you're an idiot. I'm sorry your life sucks. Have you tried to see a psychiatrist-- you can trust them and they can write you a script for xanax, or a script for shut your mouth, tid. :p

Anonymous said...

With the statement above: I'm sure you wanted to always be a primary care doctor. Sorry you didn't score or interview well enough to get the specialty you wanted. Sucks man, I'd be angry too for sure. Maybe try harder next time? Or become a PA or NP. Lmao. Haters.

Traveling the World said...

you are on of the most ignorant people I've ever experienced. I work with amazing NPs and PAs who are extremely educated. Plus, I work in a neurological ICU in one of the top hospitals in the US. So you need to do your research a little better. These NPs and PAs are experienced and take pride in what they do. As an RN who is going back to school to become a NP or CRNA, I just want to let you know that we do a lot more than hold peoples hands you ignorant POS.

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Anonymous said...

I am not protesting your comment that NPs are less trained and experienced than specialists.My real concern with your unprofessional and insensitive rant is your absolute refusal to hire a nurse practitioner. I find this remark derogatory and offensive to these highly educated professionals. It is people like you and posts like this that make the healthcare world such a demeaning place for nurses like myself, and I certainly hope that someday you are able to look past your elitist prejudices and see these "unequal" professionals for their true value, passion for their clients, and desire to better themselves and their practices.

Anonymous said...

I find this post and its author extremely ignorant and unprofessional. Nurse practitioners and Physician Assistants are highly trained and qualified MEDICAL PRACTITIONERS, and deserved to be treated with as much respect, REGARDLESS OF THEIR TRAINING, as medical doctors. The comment about NPs sticking to holding hands was absolutely uncalled for and infuriating. I am dumbfounded by the stupidity and arrogance of people such as yourself.

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Anonymous said...

Umm...who do you think teaches Physicians during their Residency programs? The NURSES! They keep the well-intentioned yet naive physicians from harming patients. Nurses are also constantly studying the pathophysiology of their patients' diseases. And observing firsthand the effects of various treatment methods. I would even dare to say that being a critical care nurse is very similar to a physician residency program.