Doctor Shortage-Who Should Fill the Gap?

I understand that, but what was initially an "outlier" philosophy with respect to the DNP is gaining immense traction, as programs are popping up all over. How long until the "outlier" philosophy of reimbursement gains traction as well?

I seriously doubt that NPs would turn down equivalent reimbursement as physicians, especially since so many of them feel they provide the same services as physicians. Which brings us back to the original question-How do NPs make things cheaper?

In essence, and maybe just in philosophy, the owner of the practice, the MD is able to see more people with a team of professionals and oversees the care. The MD will then see the patients that are beyond the scope of practice/or knowledge of the NP.
The costs will be cheaper as an average.
Medicare reimbursement is NOT what the patient costs the team treating them. It is about 80% The rest of the cost is picked up by private insurances; tacked on to other peoples costs. (higher costs for private pay). If the team can see a "quanity" of patients, then the cost is spread out.
The office, the staff, the supplies and the equipment is a static amount. More patients seen more of the overhead is covered. Basic economics.

It's not always basic economics. Sometimes the more patients one sees, the more overhead is needed. That is why every practice does not have just one LPN or PCT for vitals, one scheduling secretary, one coder, one biller, etc. As the practice grows, so grows the overhead.

And what about the states where NPs are autonomous and may own their own practices and have no one overseeing them? Are you telling me that they are going to accept lower reimbursement than a physician's office next door who is doing the "same" thing? I don't think it will happen.

I'm in California. NP do not practice independently. (they have to have an agreement with a MD for referral. I can't speak for other states.

FACTS TO PONDER:

(A) The number of physicians in the U.S. is 700,000.
(B) Accidental deaths caused by Physicians per year are 120,000.

(Calculation) Accidental deaths per physician is 0.171

Statistics courtesy of U.S. Dept of
Health Human Services.

Now think about this:
Guns:
(A) The number of gun owners in the U.S. is 80,000,000.
(Yes, that's 80 million..)
(B) The number of accidental gun deaths per year, all age groups, is 1,500.

(Calculation) The number of accidental deaths per gun owner is .000188

Statistics courtesy of FBI

So, statistically, doctors are approximately
9,000 times more dangerous than gun owners.

Remember, 'Guns don't kill people, doctors do.'


FACT: NOT EVERYONE HAS A GUN,
BUT ALMOST EVERYONE HAS AT LEAST ONE DOCTOR.

Please alert your friends to this alarming threat.
We must ban doctors before this gets completely out of hand!!!!!

Out of concern for the public at large,
I withheld the statistics on lawyers for fear the shock would cause people to panic and seek medical attention.

Funny, but I put this in for a reason. There is always a different way of looking at things.
(By the way, the data is accurate!)

I'm sorry, but how is this related to the subject at hand? A chain E-mail from prior to 2003 likely created by some NRA wingnut?

http://www.breakthechain.org/exclusives/drguns.html

And the part in bold is not part of the original E-mail, meaning you put it in there. You verified these stats personally?

Take a pill! I thought it was funny!

No pill necessary...you said the stats are accurate. I was just curious how you arrived at that conclusion. But back on track...

What impact does importing doctors and nurses have on the countries they are leaving? Does it increase political instability? If so, will this cost more than increasing domestic production of doctors and nurses? Is there really a shortage?

Hello all, PA here.

I was, not surprisingly, a little disappointed in the way PAs were represented in this CNN piece. The one PA, Mike Jones, is a member of the PA forum where I moderate. We (Mike, myself, and hundred of PAs on the forum) have discussed these issue extensively over the years. What is the PA role in PC? How does it mesh w/ NPs? Will DNPs some day be supervising PAs? Will PAs ever get a pathway to independence outside of traditional medical school?

Mike is one of the more even keeled PAs I know and unfortunately he comes off sounding like the stereotype many docs (& others) have of PAs or "midlevels"......think they know more than docs, too big for their britches, a DANGER to patients. The latter is clearly unfounded but the lay public will not question it.

We've come an imperceptible way, baby.

What struck me was the one pt response (Bernardne Amadi)- the NP was a dedicated clinician (no doubts from me on that), the PA was ignorant/uninformed/etc....

It seems that CNN, probably out of ignorance or carelessness, failed to portray PAs accurately. No counterpoint of the relative safety of pt care from docs and THEIR medical errors in diagnosis, of course. An anecdote which paints PAs poorly.

The most frustrating thins of all.....I work in a multispecialty clinic, heart care. Our surgery side uses all PAs; the medical side (general, failure, EP) uses all NPs. We confer w/ each other. We're cordial. No one is overtly or covertly (to anyone's knowledge!) dissing the other's training or credentials. Yet the PA vs NP "thing" is very real in some circles.

There's enough pts for all of us, that's for sure. I would hope many of you all fel the same way.......

big article on NPR as well about the confusion about the DNP and many are feeling thats physicans are feeling threaten, but who is going to filll the gap? I don;t think patients will be confused, nurses are usually very good at explaining their role about what they do but of course this can problematic for many if the patients assume and not questions are asked or no explaination given..I didn't understand it at first, and I was going to get a Phd but I it if you don't want to teach or do research then it was not going to fit into my plans, You have to have a be a NP to be DNP is my understanding or CS- since its clinical..

http://www.npr.org/templates/story/s...ryId=100921215