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re: How do you feel about Nurse Practitioners?

Posted on 3/20/24 at 3:26 pm to
Posted by Jake88
Member since Apr 2005
68508 posts
Posted on 3/20/24 at 3:26 pm to
quote:

quote:
Why do they create large bills but accept 10-20%, I don't know.


Maybe so they can write off larger amounts of unpaid bills? I have no idea
Then we need an MBA or Accountant to answer that, not a doctor.
Posted by Boudreauboudreaugoly
Land of the Rice n Son
Member since Oct 2017
1217 posts
Posted on 3/20/24 at 3:28 pm to
No exam I know of involves bend over and cough. What exam are you referring to. Please elaborate.
Posted by Epic Cajun
Lafayette, LA
Member since Feb 2013
32858 posts
Posted on 3/20/24 at 3:29 pm to
quote:

Apparently not. I always thought the board rooms of hospitals and medical groups were made up of doctors.

Some hospital system execs are physicians, some are not. Most of the time the CEO will not be a physician.
Posted by tgrbaitn08
Member since Dec 2007
146214 posts
Posted on 3/20/24 at 3:30 pm to
quote:

No exam I know of involves bend over and cough. What exam are you referring to. Please elaborate.



A hernia and/or prostate exam
Posted by Epic Cajun
Lafayette, LA
Member since Feb 2013
32858 posts
Posted on 3/20/24 at 3:34 pm to
quote:

Pretty much is the main issue with healthcare in general. Every aspect of it is run by non medical personnel.

Healthcare providers get taught zero regarding business in medical school. Some of the worst business people are medical professionals. I would say that physicians who also get MBAs would be the best folks to run healthcare organizations.
Posted by yellowfin
Coastal Bar
Member since May 2006
97770 posts
Posted on 3/20/24 at 3:38 pm to
I’ve seen it first hand, medical professionals should be no where near the business side

Also agree business side shouldn’t dictate patient care
Posted by Dragula
Laguna Seca
Member since Jun 2020
4996 posts
Posted on 3/20/24 at 3:45 pm to
quote:

I always thought the board rooms of hospitals and medical groups were made up of doctors.


Hospital entity senior leadership is typically is comprised of:

President - Large majority is Non-medical

Chief Medical Officer (CMO) - is a Physician and is over the physicians

Chief Nursing Officer (CNO) - is a RN, typically a DNP over all nursing

Chief Financial Officer (CFO) - Accounting exec, in charge of financials

Support services President - over non medical services
This post was edited on 3/20/24 at 3:46 pm
Posted by buffbraz
Member since Nov 2005
5678 posts
Posted on 3/20/24 at 3:51 pm to
quote:

The only time i wouldn’t would be if i were seeing a specialist (cardiologist, dermatologist, etc.) for something that goes beyond the scope of primary care. Those specialist MDs went to school for years extra to focus on that one specialty.


Certainly don’t want to take away from the grueling training of medical school, combined with residency. It is very hard and not a lot of people can do it…….having said that, in my clinical experience, over the years I have completed probably 50,000 biopsies, diagnosed thousands upon thousands of BCC, SCC, and 100s of melanomas. If these patients had waited to see a dermatologist, there would have been increased morbidity and mortality. In addition, I have a strong passion for immunology and have extensive experience with the biologic medications we use for conditions such as psoriasis and eczema. I am equally or even more well versed in these treatments than the MDs in our practice due to my patient population. People should have the option of what type of provider they want to see, but especially in a rural setting they don’t always have that option. Advance practice providers can and do excel in areas other than primary care. You might be surprised to learn that many of the thought leaders in medical specialties are APPs.
Posted by deltaland
Member since Mar 2011
91064 posts
Posted on 3/20/24 at 3:57 pm to
They do all the work and know just as much as the doctor











At least that’s what they all tell me
Posted by tgrbaitn08
Member since Dec 2007
146214 posts
Posted on 3/20/24 at 3:59 pm to
quote:

I’ve seen it first hand, medical professionals should be no where near the business side

Also agree business side shouldn’t dictate patient care


this is 100%....medical professionals are the worst business minded people ever and they are terrible with money

I'd trust a lawyer with my money before I'd trust a Doctor and that's not saying much
Posted by Epic Cajun
Lafayette, LA
Member since Feb 2013
32858 posts
Posted on 3/20/24 at 4:03 pm to
quote:

Hospital entity senior leadership is typically is comprised of:

President - Large majority is Non-medical

Chief Medical Officer (CMO) - is a Physician and is over the physicians

Chief Nursing Officer (CNO) - is a RN, typically a DNP over all nursing

Chief Financial Officer (CFO) - Accounting exec, in charge of financials

Support services President - over non medical services

Usually a COO as well.
Posted by Dragula
Laguna Seca
Member since Jun 2020
4996 posts
Posted on 3/20/24 at 4:08 pm to
quote:

They do all the work and know just as much as the doctor











At least that’s what they all tell me



In the 100s of NP/PAs over the years I've never had a single one say this, quite the opposite actually.

Most know when they are in over their head.
Posted by RogerTheShrubber
Juneau, AK
Member since Jan 2009
262355 posts
Posted on 3/20/24 at 4:08 pm to
For normal stuff, not a problem. They give antibiotics and send you home, tell you to call back in a few days if its not better.... just like the docs.
Posted by foosball
Member since Nov 2021
1926 posts
Posted on 3/20/24 at 4:12 pm to
Practitioner? Hardly know her
Posted by austiger
Austin
Member since Apr 2012
751 posts
Posted on 3/20/24 at 4:30 pm to
I've had better care from a master's in nursing than from an MD.

It really just depends on the caregiver and his/her skills.
Posted by LaLadyinTx
Cypress, TX
Member since Nov 2018
6107 posts
Posted on 3/20/24 at 4:42 pm to
quote:

You think doctors are setting that price, not the hospital that has to offset the cost of that same procedure done for free on the 4 indigent patients that had it done just before you? Do you think your insurance actually pays that amount?



He said doctors. Not the hospital. There are 2 different portions of bills IF you are in a hospital. There is a hospital component that is paid to and billed by the hospital. There is a professional fee paid to and billed by the physician. They are usually 2 totally separate things. Most hospitals are not doing physician billing unless they own a physician clinic. Then it's a doctor visit and you aren't in the hospital.

If you go to a doctor's office, the physician group determines the fee.

In pretty much every setting, jacking up charges doesn't have the impact it used to. It doesn't usually result in higher reimbursement and it doesn't matter at all, especially at a physician office because the copay is set by your insurance and the fee screens paid to the doctor are also set by insurance. Almost all the doctors are not taking any indigent patients that aren't paying. They do take self pay, but expect those patients to pay before they leave.
Posted by Gus007
TN
Member since Jul 2018
12092 posts
Posted on 3/20/24 at 4:59 pm to
I believe Nurse Practitioners are more qualified than Drs were a few decades ago.
However they were just as guilty as MDs by following government dictates during Covid, as well as the zero pain tolerance goals a decade ago. That led to the Opiod scandal.
Posted by saderade
America's City
Member since Jul 2005
25754 posts
Posted on 3/20/24 at 5:03 pm to
I wish they would overhaul their education process and experience requirements. I know some great experienced NPs but their schooling is lacking big time imo (especially if they are in a state with independent practice). Someone coming out of school, that could be online, with only 500 clinical practice hours and working with minimal oversight is scary as frick.
Posted by AMS
Member since Apr 2016
6498 posts
Posted on 3/20/24 at 5:11 pm to
quote:

All primary care should be NPs and PAs. MD should just be specialists. This could help with Dr shortage and medical costs.


except that idea is absolutely horrifying. primary care is the last place midlevels belong. this is the broadest scope for which they are least qualified to practice.

midlevels are best utilized under specialties where scope is more narrow and specific. like a midlevel for a cardiologist to follow up on your ldl and risk stratification.
Posted by Jake88
Member since Apr 2005
68508 posts
Posted on 3/20/24 at 5:14 pm to
quote:

 Someone coming out of school, that could be online, with only 500 clinical practice hours and working with minimal oversight is scary as frick
Online school and 13 weeks of probably just observing not doing. Sketchy and they believe they are ready.
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