[SMK1]

Originally Posted by hardcorae

You took the words right out of my mouth. I had my first UTI at 15. Not knowing what it was, I let it go on for a few days and ended up in some pretty intense pain. I finally went to my MD's office only to have her ask me "what kind of soap do you use down there?" I was sent home after having been told to use something hypoallergenic. I remember thinking to myself, "what the...?" Even at 15 I knew this wasn't the problem.

That night, my mom brought me to an afterhours ambulatory clinic. The MD there diagnosed the UTI and prescribed me some Bactrim. All was well until the infection recurred-- again and again, nearly once a month.

Finally, one day, I came down with a UTI that hit me so hard and fast that I told my mom I had to see someone NOW. The wait at my MD's office was 3 days so we went to an NP-run clinic. Sure, the NP diagnosed the UTI and gave me Bactrim just as the MDs had, but she incorporated one thing into her care that no one else had thought to do: she taught me prevention. I followed her instructions and haven't had a UTI since.

To this day, it amazes me that something so simple managed to elude the multiple MDs who treated me-- even when with every visit I asked, "why is this still happening?"

I'm happy to say that the NP who treated me that day is still my PCP, 7 years later. :hatparty:

so glad you were able to be helped finally as well! I know that not all M.D./D.O. 's are this way, but the blanket inference that any M.D. care has to be better than an N.P. is just LUDICROUS!

[Ventjock]

first of all why would any NP/PA want to work in one of these clinics?

they arent being used to full potential...its just as if you took a NP/PA job and ended up doing MA work.

u can blame the reporters, but also the NP/PAs who decide to take these jobs are also to blame. they after all are the ones to decide to take these jobs.

[gauge14iv]

From the discussions I have been exposed to, NP's in minute clinic are only allowed to diagnose and prescribe what the computer program minute clinic uses TELLS them they can. Yup...you heard me right.

I do not understand why ANY NP would want a job like this! But then I don't live in an area where NP jobs are scarce.

[Ventjock]

Originally Posted by gauge14iv

From the discussions I have been exposed to, NP's in minute clinic are only allowed to diagnose and prescribe what the computer program minute clinic uses TELLS them they can. Yup...you heard me right.

I do not understand why ANY NP would want a job like this! But then I don't live in an area where NP jobs are scarce.

exactly thats what ive read too.......the machine tells you what to do...

again I do not understand why ANY NP or PA would want a job like this!

this just belittles the skills of mid-levels and more of the public will see them as "true" assistants.

[gauge14iv]

In some areas of the country NP jobs are VERY scarece - I predict minute clinic will have a tougher time coming into a market where NP jobs are more availabel and pay is higher.

[SmilingBluEyes]

The military makes extensive use of NP's in all kinds of areas, like Peds, Internal Medicine, Family Practice, and Obstetrics, to name a few. I have to say the most thorough exams and assessments I have had were done by NP's, not doctors. It's just the truth. I can't imagine they compromise my safety in any way. They are thorough---- and excellent teachers.

[Nurse Ratched]

My objection is the likelihood that folks will rely heavily on such services and avoid having a PCP. Working with my pt population, it's not uncommon for them to have been seen in multiple "doc in a box" settings for a concern, then show up at our office and you have to try and figure out the whole story.

When we have a patient who is seen consistently, patterns develop in the medical record which are useful in patient education. F'rinstance, 90% of the folks in our area have some form of seasonal allergies. It usually takes 2-3 years of folks coming in at the same time of the year for the same reason: chief complaint "cold for a month" (just sure they need antibiotics) until we have enough documentation that they believe us.

Again, for me it's not a NP/PA/MD issue - it's continuity of care. When patients go for care where they happen to be shopping at that moment, the health care is too fragmented and the likelihood of a missed pattern indicating a more chronic or serious health problem is increased. It might work better if our patients were better historians, but many of them just aren't.

[gauge14iv]

[quote=When patients go for care where they happen to be shopping at that moment, the health care is too fragmented and the likelihood of a missed pattern indicating a more chronic or serious health problem is increased.[/QUOTE]



THAT is what is a danger to a client's health - not the care provided by the NP.
NP's must fight this practice model in order to advocate for patients. In the long run, NP's are not doing themselves or the patients they see any real favors by practicing at the local McDocs.

It is understandable that some people might have need for these services at a time when their doc is closed or in the case of a PCP office who has no way to handle same day appointments. Thats the niche these places are designed to fill, but I assure you they will fill another as well - that of the client who has no PCP.

The physician on the news show had every reason to be concerned, but not about the care provided by NP's!!!!

[cjcsoon2brn]

Well I hope to be a Nurse Practioner eventually and open my own clinic, but certainly not in a grocery store or a CVS. Anyways, I am not really surprised by this at all. I never see the media portraying nurses in a positive light, maybe its just when I'm not watching TV or reading the paper. Now, think about it. How could some nurse be as smart and qualified to provide primiary patient care as a physician? Thats just crazy talk! Next thing your gonna tell me is that women can be physicians and men can be nurses! Now that is insane.

(BTW I hope y'all know I'm being sarcastic.)

[NRSKarenRN]

UPDATE:from Center for Nursing Advocacy


UPDATE -- "Today" quick clinic campaign on fire
December 4, 2005 -- Over the past two weeks, 3500 nursing supporters have sent letters to NBC's "Today" show. They have objected to the November 14 segment in which nurse practitioner (NP) care at "quick clinics" was portrayed as fast, cheap and out of control, and in which AMA President Edward Hill was allowed to deliver unfounded criticism of the quality of NP care, with no response from an NP. Letters came from every part of the United States and abroad, from nurses in rural clinics, major teaching hospitals, and the military, and from patients and physicians. An astonishing 42% of the letters were original.

Because of this outpouring of concern, the Center has been able to establish a contact with a "Today" show producer. He has promised to work with us on presenting accurate information about nurses through "Today" and possibly other venues. We plan to continue to push the show to take steps to repair the damage caused by the Nov. 14 segment. We understand that a statement about this segment from the "Today" show is forthcoming, but it was not available in time for this news alert. We plan to set up a working group of nursing organizations to pitch story ideas about nurses to the show on a regular basis. To learn more about being part of this working group, please contact us.

If you have an idea for the show, please send a one paragraph summary to storyidea@nursingadvocacy.org. AMA President Hill has not responded to the 3500 letters the AMA has received, and he has failed to return our many calls asking for a dialogue. Please click here to send our new letter to the AMA asking it to base policy positions about nurses on research, rather than bias or economic self-interest. Thank you. See our analysis of the "Today" quick clinic segment here.