I do not want to see an NP!

[Anonymous]

Anonymous wrote:

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Anonymous wrote:That's your right OP. If that's what you want and willing to wait, insist on it. DW is a cardiology NP and had a patient like you. Rather than seeing DW, wanted to wait 6 weeks for a doctor. The idiot died of heart attack while waiting. DW could've saved his life by catching his problems but what can you do.

Pretty shocking that you refer to your wife’s deceased patient as, “an idiot.” Such compassion.

Since I assume you heard the tale from her, that is even more appalling.

Another take on this might be that it was highly irresponsible (malpractice?) for the office to put off a patient with a life-threatening condition for six weeks, when all he wanted was to see his doctor. But still they found no way to move up his appointment.

Some practices might have felt awful about this turn of events. The incident might have caused them to investigate how the case was handled…but your wife and her colleagues just wrote this poor caller off as “an idiot. “

Please do share the name of the practice , if you think they operate to such a high standard.

yeah, no. that's not how it works. when you are a patient of the practice you are a patient of the practice, and you need to agree to how they manage cases. if you don't like it you should find another practice. But it's simply not a thing to insist on "I want to see the doctor and nothing else is acceptable." The practice decides how to triage cases. If this guy had come to his scheduled appt the NP would certainly have been able to coordinate his care and get him what he needed, but the patient refused. Patients have agency in their care. This was an unfortunate outcome but hardly the fault of the practice.

This is incorrect. “The practice” does not set the standard of care.

Not sure what you think “ standard of care” means. Patient refused appointment. Had a deadly outcome. The practice had no obligation to let him pick his provider, they gave him an inroad to care and he declined. As unfortunate as this situation is, nobody who knows the first thing about healthcare would call this “malpractice.”

Says who?

Says anyone who knows anything about practice management. Says anyone who had read the "patient bill of rights." It's not Wal-Mart, you're entering a practice as a patient and should be made aware of how they triage visits and to whom so you can go elsewhere if it doesn't suit you. That's totally legit. But you have no "right" to any particular doctor. I mean try it, tell the risk and quality management director that you have the right to a certain doctor and see what they tell you.

Tell the jury that “the practice” didn’t abandon a patient when they sought to see a physician with whom they had an established relationship, were refused, and were not warned of the dangers of delaying attention. Go ahead. Tell them that.

The midlevels don’t care. They disappear when the servers come knocking. It’s the doctors who are ultimately liable.

Unlike you, I'm a practicing lawyer. You're wrong.

[Anonymous]

Take a quick read about that poor little 8 year-old who died in ICE care and see how great those NPs are at referring out.

[Anonymous]

One thing that is alarming is that (particularly in OB care) the "easy/low-risk" patients go to NPs, and the high-risk ones with MDs. Guess what, even in a super healthy, young Olympic athlete, a low-risk pregnancy can turn high-risk VERY fast and it often takes a higher-level specialist to spot those signs.

In my case it turned out fine but I was with a top-tier hospital.

[Anonymous]

Anonymous wrote: Fine. Get rid of NP's and PA's. Have fun being seen by FMGs.

I'd happily be seen by a doctor who's passed STEP 1, 2, and 3 and completed at least ten thousand of hours of supervised training in residency over an RN who graduated from a one year online program.

https://www.nursingprocess.org/online-1-year-...tioner-programs.html

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:That's your right OP. If that's what you want and willing to wait, insist on it. DW is a cardiology NP and had a patient like you. Rather than seeing DW, wanted to wait 6 weeks for a doctor. The idiot died of heart attack while waiting. DW could've saved his life by catching his problems but what can you do.

Pretty shocking that you refer to your wife’s deceased patient as, “an idiot.” Such compassion.

Since I assume you heard the tale from her, that is even more appalling.

Another take on this might be that it was highly irresponsible (malpractice?) for the office to put off a patient with a life-threatening condition for six weeks, when all he wanted was to see his doctor. But still they found no way to move up his appointment.

Some practices might have felt awful about this turn of events. The incident might have caused them to investigate how the case was handled…but your wife and her colleagues just wrote this poor caller off as “an idiot. “

Please do share the name of the practice , if you think they operate to such a high standard.

yeah, no. that's not how it works. when you are a patient of the practice you are a patient of the practice, and you need to agree to how they manage cases. if you don't like it you should find another practice. But it's simply not a thing to insist on "I want to see the doctor and nothing else is acceptable." The practice decides how to triage cases. If this guy had come to his scheduled appt the NP would certainly have been able to coordinate his care and get him what he needed, but the patient refused. Patients have agency in their care. This was an unfortunate outcome but hardly the fault of the practice.

This is incorrect. “The practice” does not set the standard of care.

Not sure what you think “ standard of care” means. Patient refused appointment. Had a deadly outcome. The practice had no obligation to let him pick his provider, they gave him an inroad to care and he declined. As unfortunate as this situation is, nobody who knows the first thing about healthcare would call this “malpractice.”

Says who?

Says anyone who knows anything about practice management. Says anyone who had read the "patient bill of rights." It's not Wal-Mart, you're entering a practice as a patient and should be made aware of how they triage visits and to whom so you can go elsewhere if it doesn't suit you. That's totally legit. But you have no "right" to any particular doctor. I mean try it, tell the risk and quality management director that you have the right to a certain doctor and see what they tell you.

Tell the jury that “the practice” didn’t abandon a patient when they sought to see a physician with whom they had an established relationship, were refused, and were not warned of the dangers of delaying attention. Go ahead. Tell them that.

The midlevels don’t care. They disappear when the servers come knocking. It’s the doctors who are ultimately liable.

Unlike you, I'm a practicing lawyer. You're wrong.

Outside of FPA states, why don't mid-levels carry malpractice insurance?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:That's your right OP. If that's what you want and willing to wait, insist on it. DW is a cardiology NP and had a patient like you. Rather than seeing DW, wanted to wait 6 weeks for a doctor. The idiot died of heart attack while waiting. DW could've saved his life by catching his problems but what can you do.

Pretty shocking that you refer to your wife’s deceased patient as, “an idiot.” Such compassion.

Since I assume you heard the tale from her, that is even more appalling.

Another take on this might be that it was highly irresponsible (malpractice?) for the office to put off a patient with a life-threatening condition for six weeks, when all he wanted was to see his doctor. But still they found no way to move up his appointment.

Some practices might have felt awful about this turn of events. The incident might have caused them to investigate how the case was handled…but your wife and her colleagues just wrote this poor caller off as “an idiot. “

Please do share the name of the practice , if you think they operate to such a high standard.

yeah, no. that's not how it works. when you are a patient of the practice you are a patient of the practice, and you need to agree to how they manage cases. if you don't like it you should find another practice. But it's simply not a thing to insist on "I want to see the doctor and nothing else is acceptable." The practice decides how to triage cases. If this guy had come to his scheduled appt the NP would certainly have been able to coordinate his care and get him what he needed, but the patient refused. Patients have agency in their care. This was an unfortunate outcome but hardly the fault of the practice.

This is incorrect. “The practice” does not set the standard of care.

Not sure what you think “ standard of care” means. Patient refused appointment. Had a deadly outcome. The practice had no obligation to let him pick his provider, they gave him an inroad to care and he declined. As unfortunate as this situation is, nobody who knows the first thing about healthcare would call this “malpractice.”

Says who?

Says anyone who knows anything about practice management. Says anyone who had read the "patient bill of rights." It's not Wal-Mart, you're entering a practice as a patient and should be made aware of how they triage visits and to whom so you can go elsewhere if it doesn't suit you. That's totally legit. But you have no "right" to any particular doctor. I mean try it, tell the risk and quality management director that you have the right to a certain doctor and see what they tell you.

Tell the jury that “the practice” didn’t abandon a patient when they sought to see a physician with whom they had an established relationship, were refused, and were not warned of the dangers of delaying attention. Go ahead. Tell them that.

The midlevels don’t care. They disappear when the servers come knocking. It’s the doctors who are ultimately liable.

Unlike you, I'm a practicing lawyer. You're wrong.

Outside of FPA states, why don't mid-levels carry malpractice insurance?

Why do you assume they don't? Everyone I know is covered by a hospital held policy.

[Anonymous]

Anonymous wrote:One thing that is alarming is that (particularly in OB care) the "easy/low-risk" patients go to NPs, and the high-risk ones with MDs. Guess what, even in a super healthy, young Olympic athlete, a low-risk pregnancy can turn high-risk VERY fast and it often takes a higher-level specialist to spot those signs.

In my case it turned out fine but I was with a top-tier hospital.

Not really. All they need to be able to do is recognize when something strays from normal.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I find that the NP’s and the PA’s in the practice I go to are excellent. They seem to be much more thorough and take more time with the patients than the Md’s. If there is something drastically wrong they consult immediately with the MD’s.

I much prefer NPs for my annual GYN exam. If it's a serious illness or condition, sure, I'd like a doctor, but for routine stuff I find that they are willing to take more time and ask more questions. And if something is wrong, they consult the doctor.

+100

I like NPs I feel like they're more down to earth, easily approachable, and more relatable.. Doctors have the textbook knowledge, but the nurses have the clinical skills bc it's so routine for them.

NPs and PAs are middle class providers for middle class people.

Doctors are upper class providers for upper class people.

Um, no. What a strange take.

Well we do know that the uber wealthy have their own personal doctors and probably would consider themselves above an NP. So if she considers "upper class" only the .001%, then she's right. However, those who have their own doctors and consider those doctors to be the medical equivalent of a server in a restaurant often have worth health outcomes because they demand unnecessary interventions.

My in.laws have a private doctor who only takes a small amount of patients and they pay a monthly fee on top of medical expenses. I would bet the doctor has an NP. I would want the doctor to have someone to consult with someone who also knows the patients. They aren’t in the .001%.

[Anonymous]

The option of a concierge practice exists for a fee

[Anonymous]

Anonymous wrote:The option of a concierge practice exists for a fee

But then not all concierge doctors go extra mile to coordinate care with specialists. Most of the good ones in McLean/Vienna/Fairfax/Falls Church are not taking new patients.

There was a recent thread on this topic. Pandemic changed everything. I tried changing my concierge doctor recently (primarily due to no help with specialists) and was shocked that most have full practice and are not taking new patients. If you aware of good concierge doctors in this area, please post names.

[Anonymous]

Anonymous wrote:

Anonymous wrote:One thing that is alarming is that (particularly in OB care) the "easy/low-risk" patients go to NPs, and the high-risk ones with MDs. Guess what, even in a super healthy, young Olympic athlete, a low-risk pregnancy can turn high-risk VERY fast and it often takes a higher-level specialist to spot those signs.

In my case it turned out fine but I was with a top-tier hospital.

Not really. All they need to be able to do is recognize when something strays from normal.

And all a 747 pilot needs is to know what buttons and levers to push and when to push them.

[Anonymous]

If people want to see an NP then they should feel free to so that. I will not. NP training is very disjointed and not very comprehensive. They frequently practice outside their scope. The nurse lobby is so strong they have convinced people that NPs are just as good as family medicine physicians. This is simply false. The NP slogan heart of a nurse brain of a doctor is false!
There are bad medical professionals all over the place. So doctors can and will make mistakes. But NPs are a special breed. They don't know what they don't know and they are not adequately trained or supervised.

[Anonymous]

Anonymous wrote:If people want to see an NP then they should feel free to so that. I will not. NP training is very disjointed and not very comprehensive. They frequently practice outside their scope. The nurse lobby is so strong they have convinced people that NPs are just as good as family medicine physicians. This is simply false. The NP slogan heart of a nurse brain of a doctor is false!
There are bad medical professionals all over the place. So doctors can and will make mistakes. But NPs are a special breed. They don't know what they don't know and they are not adequately trained or supervised.

The nursing lobby is relatively weak, especially in comparison to the physician lobby. Historically, mid-level practice was promoted by physicians - they could collect half the billings of the NPs or PAs they supervised. Anesthesiologists, in particular, could run 4 ORs with 4 CRNAs, while collecting a ton of fees. The anesthesiologist only has to be present for the critical phases.

I don't care whether you like or dislike midlevels, but don't fool yourself into believing a false narrative. It's clear that you have some attitude issues that you might want to address before disparaging others.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I find that the NP’s and the PA’s in the practice I go to are excellent. They seem to be much more thorough and take more time with the patients than the Md’s. If there is something drastically wrong they consult immediately with the MD’s.

I much prefer NPs for my annual GYN exam. If it's a serious illness or condition, sure, I'd like a doctor, but for routine stuff I find that they are willing to take more time and ask more questions. And if something is wrong, they consult the doctor.

+100

I like NPs I feel like they're more down to earth, easily approachable, and more relatable.. Doctors have the textbook knowledge, but the nurses have the clinical skills bc it's so routine for them.

NPs and PAs are middle class providers for middle class people.

Doctors are upper class providers for upper class people.

I'm upper-class and have had a mix of doctors and NPs. I prefer NPs who will spend the time on a routine visit chatting about what's going on with my medical history. Doctors run in, give you 5 minutes and then hand it off to someone else. Either way, you may "see" a doctor but they aren't really doing much more.

[Anonymous]

The 3 NPs I have seen all graduated from Georgetown.