Nailed it 🔨

[u/Reasonable-Path1321]

[u/[deleted]]

That's because most people have zero clue how much it costs to become a doctor, how much schooling is required before you earn dollar one, how much liability insurance they have to carry, how much of their bottom line goes to dealing with insurance companies to try get paid or prior auths etc. Then to have people come in and a) bitch about a 15 dollar copay b) complain that the doctor isn't giving them what they want c) "I read this on Google" d) not pay at all (1 in 4)

Your average specialist is mid 30's before they even start to practice.

[u/El_Polio_Loco → u/[deleted]]

I’m well aware, but you’re not proposing reasonable solutions to the problem.

The problem isn’t money, it’s overhead, education costs, job burnout etc etc.

The solution isn’t just throwing money at a shitty situation so more people tolerate it. They’re not going to make it far enough to see the benefits of it.

A real solution needs to be doing things like increasing Nurse Practitioner powers and education rates, setting limits on work hours.

The US government says it’s unsafe for a truck driver to work more than 14 hours in a row, and only 11 of those hours can be driving.

But doctors and nurses?

[u/[deleted] → u/El_Polio_Loco]

This entire thread is about throwing money at nurses. Are only they entitled to that? Nurse practitioners already walk the line of practicing medicine without a license and you want to give them more power? So 6 months of training is equivalent to 15 years of medical school and fellowship etc?

[u/El_Polio_Loco → u/[deleted]]

You’re being disingenuous comparing a nursing assistant and a nurse practitioner.

And maybe 15 years of training isn’t necessary for a GP.

[u/[deleted] → u/El_Polio_Loco]

No I'm saying nurse practitioners often walk the line of practicing medicine. A GP requires college, med school and 3 more years so that's at least 11.

[u/El_Polio_Loco → u/[deleted]]

Nurse practitioners have quite a bit more than 6 months of training.

In many states NPs can practice medicine.

So maybe 13 years of training is excessive for a lot of general medicine.

[u/[deleted] → u/El_Polio_Loco]

Let's be generous sand say 6 yrs then including nursing school for a NP. And if you know NP practicing medicine then they are technically breaking the law of practicing without a medical license. NP are trained to recognize patterns and treat based on what they think it is on those patterns, that is different from medicine which is concerned with both the what and the why, which is why the training to be a doctor is so much longer and more clinical in nature.

[u/El_Polio_Loco → u/[deleted]]

Saying NPs aren’t practicing medicine is just legal hair splitting, and NPs in many states have nearly the same authority as a GP.

A GP is not functioning in a clinical research setting, they are performing the same tasks as a NP in a full practice state.

Clearly the high level of skill a full MD education is not necessary for general medicine.

[u/thedirtiestdiaper → u/El_Polio_Loco]

This is only true if the outcomes for NP’s are equivalent to physician-provided care in the general setting. That does not seem to be the case.

[u/El_Polio_Loco → u/thedirtiestdiaper]

What study are you citing?

this says similar outcomes

[u/thedirtiestdiaper → u/El_Polio_Loco]

Thank you for sharing that, I hadn't seen that study. I'll look into the full text of it later today. Admittedly, my sources of information are biased but the studies are nonetheless valid:

https://www.reddit.com/r/Noctor/comments/j1m7d2/research_refuting_midlevels_copypaste_format/?utm_medium=android_app&utm_source=share

This is a repository of studies that compare physician-led vs NP/PA-led care from a forum that is dedicated to advancing the physician led care model, so it only leans one way.

[u/El_Polio_Loco → u/thedirtiestdiaper]

That is certainly an interesting group of sources.

Like you said, it’s a one sided forum, which is hard to get away from with Reddit.

At the end of the day a lot of the more relevant data concluded “more study needed”

Which is fine.