This is why...

[djmatte]

We need to advocate for equity of pay for the percentage of what we bill. Doctors are making money hand over fist for simply "supervising" mid levels. They can literally not bill for what's their salaries justify, yet continue to make money off our own work. 
 

 

[FiremedicMike, RN, EMT-P]

FullGlass said:

I find it interesting that both you and djmatte have been quite unpleasant to me on this forum multiple times in the past, yet when I disagree with you and ask you to perform some simple research to defend your position, you cry about it.

Yes, you do tend to make assertions w/o supporting them.

It literally takes me about 90 seconds to do basic research using an internet search engine.  If I can do it, then you can, too.

If I disagree with something posted here, I explain why, and if appropriate, provide evidence to support my postion.  Nothing wrong with that.  I'm not aware that people are not allowed to disagree with posts on this forum.  It would be a very dull, and rather useless, forum indeed, if all we did was agree with anything anyone wrote here.

Whether or not it is common for docs to be held liable, most physicians do not want to do anything that increases their liability risk.  Go talk to some physicians about it - not just this issue, but liability in general.  

My original point is that when an MD supervises a mid-level:

1.  It can be extra work if they actually supervise.  Would you do extra work for free?  I wouldn't.

2.  It absolutely increases their liability if they are in a formal supervisory role.  That is another reason they want to get paid for supervising.  That is also why some docs, even if they are offered payment, do not want to supervise any mid-levels.

Listen bub, I think you need to revisit the flow of this conversation, the aggression started with you.

You continue to assert that I can't do a simple internet search, I have repeatedly stated that I already did.  I guess we're at an impasse.

[FullGlass, BSN, MSN, NP]

djmatte said:

He arguably just asked the question. And as expected and is characteristic someone decided to jump down his throat demanding he do some research. It's reasonable to suggest that doctors have been held liable for their own, or the work of clinicians that they were "supervising". The article also indicates that a significant portion of those doctors weren't really doing any supervision in the first place, despite their obligations to do it. If anything, that article simply supports a rationale for independent practice as doctors have stated over and over again they don't want that liability.

You have been extremely rude to me in the past.  Yet, when I ask for someone to back up their argument, you are suddenly very sensitive.  

I agree that most doctors really don't do substantive supervision of mid-levels, but that is not the point here.  In fact, if a doctor has a formal supervisory role, and does not properly supervise, that is a huge increase in their liability risk.  

I agree with you that NPs should have FPA after they have at least 1 year of experience, preferably 5 years.

[FullGlass, BSN, MSN, NP]

FiremedicMike said:

Listen bub, I think you need to revisit the flow of this conversation, the aggression started with you.

You continue to assert that I can't do a simple internet search, I have repeatedly stated that I already did.  I guess we're at an impasse.

Wow!  I disagree with you and ask you to back up your argument adequately, which you have failed to do, and now I'm being "aggressive."  Yet, it is clear from your past behavior that you felt perfectly fine being rude to me on this forum.

You simply objected to an article someone else (not me) cited.  Sorry, that doesn't support your assertion.

And it does not refute my original point, which is that if a doctor has to supervise a mid-level, they deserve compensation for that.

If someone asked you to do your regular job, and also to supervise a few other people on top of that, would you do it for free?   Would you also do it for free if you feel it increases your professional liability?

 

[MentalKlarity, BSN, NP]

FullGlass said:

I find it interesting that both you and djmatte have been quite unpleasant to me on this forum multiple times in the past, yet when I disagree with you and ask you to perform some simple research to defend your position, you cry about it.

Yes, you do tend to make assertions w/o supporting them.

It literally takes me about 90 seconds to do basic research using an internet search engine.  If I can do it, then you can, too.

If I disagree with something posted here, I explain why, and if appropriate, provide evidence to support my postion.  Nothing wrong with that.  I'm not aware that people are not allowed to disagree with posts on this forum.  It would be a very dull, and rather useless, forum indeed, if all we did was agree with anything anyone wrote here.

Whether or not it is common for docs to be held liable, most physicians do not want to do anything that increases their liability risk.  Go talk to some physicians about it - not just this issue, but liability in general.  

My original point is that when an MD supervises a mid-level:

1.  It can be extra work if they actually supervise.  Would you do extra work for free?  I wouldn't.

2.  It absolutely increases their liability if they are in a formal supervisory role.  That is another reason they want to get paid for supervising.  That is also why some docs, even if they are offered payment, do not want to supervise any mid-levels.  Docs don't do some calculation on how much it increases their liability.  They make decision based on PERCEIVED risk, which is what most people do. 

They're already making 100K profit per NP they said. Supervision should come free not on top of the profit. 

[djmatte, ADN, MSN, RN, NP]

MentalKlarity said:

They're already making 100K profit per NP they said. Supervision should come free not on top of the profit. 

I'd argue the clinic owners (often MDs) are making that number. many of those posting are corporate employees being asked to supervise or be collaborators within the system, but not specifically seeing that profit. Though it's my anecdotal experience few doctors are actively engaged with their mid levels. Especially when they own the practice. 

[FullGlass, BSN, MSN, NP]

MentalKlarity said:

They're already making 100K profit per NP they said. Supervision should come free not on top of the profit. 

As djmatte pointed out, physicians that are corporate employees are not making that profit.  As for those who own a private practice and employ NPs, so what?  They are entitled to make a profit.  And for those who posted in the exchange featured by the OP, who is paying the docs?  If a corporate practice is paying the docs extra to supervise, they deserve to be compensated for that.  Otherwise, they wouldn't do it, and if the state does not have FPA, then the NPs would not be able to work!

Right now, in any state that has FPA, any NP can go start their own practice to maximize their earnings.  If they do well, they can hire other NPs and PAs and profit off them.

Even in states w/o FPA, like CA, I've seen NPs and even RNs open their own practices or businesses.  (CA passed FPA last year, but it requires at least 5 years experience, so it will be awhile before all NPs have it).  There used to be an RN with her own aesthetics practice in La Jolla.  Having a successful practice is one of the ways for an NP to make a lot of money.

For some specialties, like psych, there are numerous telehealth platforms that will employ an NP anywhere (as long as they have the correct state licenses) on a 1099 for a lot of money.  One PMHNP posted here she made $500K last year doing exactly that.  (She also worked 50 hours per week).

Like it or not, we live in a capitalist society.  Except for providers working for the government, healthcare organizations make profits.  Even nonprofits make a "profit," but there are rules around how this is to be used.