Originally posted by CordMcNally
View Post
X
-
- Likes 2
-
Originally posted by Tim View PostFrom a non-physician perspective, huge difference between a PA and a NP.
A PA is purely a productivity enhancement too. If you train, direct, supervise and have hire/fire authority, it comes down to productivity and how effectively your personal practice can use the PA.
NP is adequately discussed above.
- Likes 8
Comment
-
I work with NP trainees and honestly it's shocking to me how poorly trained they are and what they miss on patient interviews. No way in ************************ would I supervise them. I do know a few NPs who worked as nurses for a decade or two and then got their NP and they are good. But as a rule these DNP programs are garbage. If you can work full time while completing a 2 year DNP program, you are not being adequately trained to be in a physician role. Sorry.
And if you want to be called doctor, put in the 7-10 years to go to medical school and residency and then we can talk.
- Likes 11
Comment
-
From my observation, the only physicians that are comfortable with midlevels are those that are profiting directly from their employment. Continue selling out the future generation of physicians and demeaning your training for an extra buck.
- Likes 7
Comment
-
I supervise two very experienced NP’s who were nurses for a long time before doing a brick and mortar program, and who have been practicing for years. I did random chart audits at first, and now I see notes when they see my patients in cross coverage. They know their stuff and know their limits / when to ask for help. I view this as entirely different than the baby NP’s graduated from diploma mills with 1 year of “experience” - management is hiring those people. I would never supervise one of them. I have thought about backing down on supervision, but that would be odd.
- Likes 4
Comment
-
So what actually is the purpose of putting a seen and agree on the note ? When you obviously did not see them. I see this all the time. The patient was seen sat in the urgent care and the doctor signs off on monday on the note. Really, you expect me to believe that you went in on sat , saw the patient on sat for that encounter. This is all about billing and nothing more.
- Likes 4
Comment
-
Huge variation in PAs and NPs when it comes to their training/former career background/attitude. Group has a former nurse who became a NP and the IR docs trained her to do some basic procedures. She also does the H&P for the IR docs and calls patients for f/u. She does a great job and knows her limits.
When she is off for a week everyone notices. We employ her and not the hospital.
- Likes 3
Comment
-
I work along NP's no problem, they see their own patients and bill separately. They help see some of low-level stuff but also really help with patient education and patients who need more TLC, which I'm happy to not see myself. I have no interest in supervising midlevels nor need their help in seeing patients (except those tlc patients). Seeing patients is the easy part. Fielding messages, calls, prior auths, etc. is annoying and waste of my time and I'd gladly take help for that, which our midlevels do help with sometimes too.
- Likes 1
Comment
-
Originally posted by gap55u View PostI supervise two very experienced NP’s who were nurses for a long time before doing a brick and mortar program, and who have been practicing for years. I did random chart audits at first, and now I see notes when they see my patients in cross coverage. They know their stuff and know their limits / when to ask for help. I view this as entirely different than the baby NP’s graduated from diploma mills with 1 year of “experience” - management is hiring those people. I would never supervise one of them. I have thought about backing down on supervision, but that would be odd.
- Likes 2
Comment
-
Originally posted by Lordosis View Post
That would bother me until I realized that I could brand my practice offering the "Brain of a physician" advertising "Real" care. The patients they syphon off will likely not be missed
Not efficient not access. Not glorious fancy facilities or red carpet customer service.
Plain old. Better care. It's your health after all.
Comment
-
Originally posted by Lordosis View PostThey also suck up the easier visits. Minor injuries, UTIs, URIs, Etc. Making your day more complicated and frustrating. Sure you can bill higher but I would rather see 2 99213s in place of 1 99214. It also helps keep they variety in the day and personally I like the quick stuff that makes people feel better. More satisfying compared to tweaking DM meds.
Comment
-
Originally posted by legobikes View Post
Yep, good point. I get paltry compensation for NP oversight and think I will stop doing it soon. Our PA on the other hand is pretty good.
Comment
-
Originally posted by Huggy View PostFrom my observation, the only physicians that are comfortable with midlevels are those that are profiting directly from their employment. Continue selling out the future generation of physicians and demeaning your training for an extra buck.
- Likes 1
Comment
-
Originally posted by Tim View PostFrom a non-physician perspective, huge difference between a PA and a NP.
A PA is purely a productivity enhancement too. If you train, direct, supervise and have hire/fire authority, it comes down to productivity and how effectively your personal practice can use the PA.
NP is adequately discussed above.
You said you weren't a physician, I was just curious what your background work experience has been.
- Likes 1
Comment
-
Originally posted by pit.alumni View Post
I think that's a generalization that is not really true. It may be specialty and setting dependent. There is no doubt that Private Equity is using APPs in place of physicians and then putting the risk on their employed physicians and it's bad for everyone (pts, apps and physicians) except for those profiting. On the other hand Physicians that invest in their PAs and NPs, train them well, can utilize them for tasks that do not really require a Physician level of care. In those settings the APPs can be compensated well, patients can be seen efficiently and get more face to face time with providers to get their questions answered, and the Physician owners can get reasonable compensation for the oversight.
Additionally, I don’t see “APPs can be compensated well” and “physician owners can get reasonable compensation” as compelling reasons to justify the use of midlevels but to each their own. Does that not just prove my original statement that financial interests are the primary driver for the utilization of inferiority trained medical providers? And i think it is safe to assume based on your position that you have a financial interest in the employment of midlevels in your practice, please correct me if I’m wrong.Last edited by Huggy; 05-06-2022, 07:28 AM.
- Likes 1
Comment
Channels
Collapse
Comment