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Can PCPs be the “ mid levels “ of some specialists

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  • nastle
    replied
    Originally posted by SerrateAndDominate View Post

    Removing residency trained primary care docs to serve as midlevel roles will not help with the overall need for primary care when you can have specialists train unmatched docs. Seems like a better use of the labor pool.
    Again I’m not suggesting removing them completely from their practice nor am I suggesting lower compensation for services they are rendering
    but By taking over what specialist midlevels tasks they will probably provide better service , more appropriate use of testing and lessen specialist burden.
    And it just gives pcp more time to serve their primary purpose which is first line of defence and more stake in the management of their patient

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  • Zaphod
    replied
    Originally posted by nastle View Post
    Classic case of whataboutism
    ok

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  • SerrateAndDominate
    replied
    Originally posted by nastle View Post

    I’m not defending the role of midlevels but that’s not something which you or I can change but I don’t see how adding more less qualified candidates ( than residency trained MD DO ) will improve this situation
    Removing residency trained primary care docs to serve as midlevel roles will not help with the overall need for primary care when you can have specialists train unmatched docs. Seems like a better use of the labor pool.

    Leave a comment:


  • nastle
    replied
    Originally posted by Zaphod View Post

    Yeah, how is that not different and on average better than?
    Classic case of whataboutism

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  • nastle
    replied
    Originally posted by SerrateAndDominate View Post

    We already have midlevels without residency managing patients.

    Hard to discuss docs working in midlevel style roles without bringing up the obvious labor supply. Sure, there are some less than stellar docs in that pool, but they've mostly undergone a standardized, more rigorous training than midlevels who can just change specialties.
    I’m not defending the role of midlevels but that’s not something which you or I can change but I don’t see how adding more less qualified candidates ( than residency trained MD DO ) will improve this situation

    Leave a comment:


  • Zaphod
    replied
    Originally posted by Tim View Post
    Definitely sounds like you might want to consider military service. A few other issues, like where is home.
    I dont know how one can miscontrue something like that, but oh well.

    Leave a comment:


  • Zaphod
    replied
    Originally posted by SerrateAndDominate View Post

    We already have midlevels without residency managing patients.

    Hard to discuss docs working in midlevel style roles without bringing up the obvious labor supply. Sure, there are some less than stellar docs in that pool, but they've mostly undergone a standardized, more rigorous training than midlevels who can just change specialties.
    Yeah, how is that not different and on average better than?

    Leave a comment:


  • SerrateAndDominate
    replied
    Originally posted by nastle View Post

    MDs who don’t match are different issue altogether, do we really want doctors without residency to be managing patients ? Let’s save that for another thread
    We already have midlevels without residency managing patients.

    Hard to discuss docs working in midlevel style roles without bringing up the obvious labor supply. Sure, there are some less than stellar docs in that pool, but they've mostly undergone a standardized, more rigorous training than midlevels who can just change specialties.

    Leave a comment:


  • nastle
    replied
    Originally posted by PedsCCM View Post
    We have some of this in peds. PICU and NICU “hospitalists” who are gen peds trained and work under intensivists or neos are kinda common. I’ve seen GI groups hire general pediatricians to work through likely simple GI or non-GI problems. Kinda similar to sports med in Ortho groups.

    They generally function a little above most mid levels, more like a fellow. Better question that I think we’ve discussed before is why can’t MD/DO’s who can’t match (but have passed boards) function exactly like PA’s?
    MDs who don’t match are different issue altogether, do we really want doctors without residency to be managing patients ? Let’s save that for another thread

    Leave a comment:


  • PedsCCM
    replied
    We have some of this in peds. PICU and NICU “hospitalists” who are gen peds trained and work under intensivists or neos are kinda common. I’ve seen GI groups hire general pediatricians to work through likely simple GI or non-GI problems. Kinda similar to sports med in Ortho groups.

    They generally function a little above most mid levels, more like a fellow. Better question that I think we’ve discussed before is why can’t MD/DO’s who can’t match (but have passed boards) function exactly like PA’s?

    Leave a comment:


  • nastle
    replied
    Originally posted by StarTrekDoc View Post
    Several FM/IM docs embedded within subspecialties already we're cost efficient AND operate higher level for complex cases. Remember, we're a quaternary academic center so it's a bit different there too.

    For vertically integrated systems, primary care docs function as many mid-levels to the subspecialists via coordinated service agreements.
    Please tell me more about this , which healthcare system is this ?
    thanks

    Leave a comment:


  • nastle
    replied
    Originally posted by CordMcNally View Post

    Obviously that was a general statement. There’s plumbers that make more than neurosurgeons but I think most people would prefer the average salary of the neurosurgeon.
    Only if you are plumber onboard a SSBN otherwise I’m not sure it’s deserved

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  • nastle
    replied
    No I didn’t mean same pay as midlevel
    but consider then
    3 days you do your regular FP stuff
    2 days you jam pack your schedule with initial work up visit for a plethora of nephrology orthopedic rheumatoid etc illnesses
    then you pass them on to the specialist ONLY when they go in to get a specific procedure /

    step down care
    same do the post op assessment and other routine issues , if complications arise then send back to specialist
    these 2 “specialist “ days you can do at that consultant office maybe so curbside’s are easier
    Last edited by nastle; 04-18-2022, 04:30 PM.

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  • AR
    replied
    Originally posted by CordMcNally View Post

    It's both.
    Great. Now all you have to do is elaborate on the reasons for the can'ts and we'll have the answer OP was looking for.

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  • Tim
    replied
    Originally posted by Zaphod View Post
    Less jokingly, I would take a mid level or helper role for less money for sure. Even in residency I was jealous of the first assist.

    The perfect life, always operating, never taking call, no clinic, no talking to pts, etc

    If you could somehow decrease liability, it would be perfect. Would love to operate, go home and if the phone goes off, never have it be a pt.

    I could handle that.
    Definitely sounds like you might want to consider military service. A few other issues, like where is home.

    Leave a comment:

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