unhappy doc/letter to editor

PANurseRN1 · Dec 25, 2006

Let's be clear, mid-levels do not have the equivalent education of a physician. They may have a lot of practical experience, but that is not the same as the education one receives to become a physician.

There's a place for mid-levels, but I think they do themselves more harm by trying to argue how they are just as well educated as a physician. Sorry, go course for course, curriculum for curriculum...it's not the same.

oramar · Dec 25, 2006

I can't wait to see the flaming rebutals to this "scab" statement that will appear in the weeks to follow. Imagine being a NP who has worked long and hard to get your credentials, then imagine opening your Christmas newspaper to find yourself being called a scab. OUCH! It is not exactly a new thing for NPs in Pennsylvania to find themselves disrespected by MDs. It has been going on for a long time.

arita2 · Dec 25, 2006

I can see why that physician didn't stay in the military with that kind of attitudes towards PAs and NPS.

Well, whatever your position, you seem to lack empathy for others. I am willing to bet though that you are an NA, LPN or RN without your 4 year degree, or you would not have made such a statement.

I would like you go through the effort and expense this doctor went through and see how you feel about less qualified individuals potentially replacing you. I am betting you would not feel any differently than she does. I think the "scab" statement (although harsh) is appropriate under the circumstances and I am glad words are not being minced. We need more individuals with courage of conviction to come forward and blow the whistle like this doctor has when our health care, and that of our patients, is at stake.

:smiletea2:

Noryn · Dec 25, 2006

Tazzi - I agree with you to a point. However, MA's don't receive reimbursement for their services and mid-levels do.

See I disagree with you here. MA's do receive reimbursement for their services at a lower rate than RNs do. The only difference is who is providing the reimbursement (government vs private industry).

Trauma Columnist · Dec 25, 2006

Arita2 - while I don't want to replace physicians (and wouldn't think that I could), my place in healthcare is to augment the physician, not take the place of. That said, I also contribute financially to my practice by seeing the less ill and thus saving the physicians for the more acutely ill where their knowledge and experience is needed.

And your healthcare and that of your family is NOT being negatively impacted whatsoever by mid-level practitioners. Hopefully, once you get out of school and have some experience, you will be more open-minded.

Healthcare is changing and we must change with it or lose out.

Trauma Columnist · Dec 25, 2006

Noryn - I will clarify - reimbursement in the way I meant it is that their services are billable to an insurance company, Medicaid or Medicare. MA's do not have a UPIN number, therefore their services are not reimbursable. Sorry for the misunderstanding.

Noryn · Dec 25, 2006

Yeah trauma I knew what you were talking about but my point was the basic principle is the same. The government paying an APN less that what a doctor would charge whereas a hospital would pay a MA less than what a RN would make.

Trauma Columnist · Dec 25, 2006

This goes back to the tenet that education is valued in our society. I don't object to that.

angel337, MSN, RN · Dec 25, 2006

doctors go through hell and hot water to get the credentials M.D. most people cannot and will not even attempt to do what it takes to be a doctor. i can fully understand why she is so upset. belittling another profession is not necessary of course, but if i was a doc i would not want someone assuming that less educated health practitioners are equivalent to that of a medical doctor. its no different than the LPN/RN argument. NP's work hard for their credentials also, but in the end you still are not a doctor.

Trauma Columnist · Dec 25, 2006

And I guess I don't see where the argument is - I never have said I'm equal to a physician. I augment the physician services, not replace.

Plus, I don't have to resort to name-calling to get my point across - lol

arita2 · Dec 25, 2006

traumaRUs - I don't feel my mind is closed, and while I may not have years of experience in Nursing, I do have solid experience with market economies and can safely say that we are all racing to the bottom when it comes to being replaced by less qualified workers. Less is more to big businesses, and they will do with less qualified personel to make more profit. They DO need to be carefully watched in healthcare, or we all risk being short changed in the quality of care when profits are part of the equation.

Now, there are many situations where mid-level practitioners are perfect for the level of care that is required. But you have to admitt, there is great potential for abuse by less ethical outfits.

Again, I side with the Doctor and can understand her worry and frustration. Who knows what she has seen where she practices, and if she is concerned, it may very well mean that there is good reason for her to be and that we need monitor healthcare practices to ensure abuse is not occuring. I would not dismiss the good Doctor so lightly.

To quote you, "Healthcare is changing and we must change with it or lose out." We just need to be sure the change is benificial and equitable to all.

TazziRN, RN · Dec 25, 2006

Yeah trauma I knew what you were talking about but my point was the basic principle is the same. The government paying an APN less that what a doctor would charge whereas a hospital would pay a MA less than what a RN would make.

Thanks, Noryn, that's what I was trying to say.