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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]The devolution of the US medical system to increasingly poor quality levels is the fruit of corporatization, abetted by the appalling power insurance companies have been permitted to amass over what constitutes “appropriate” care. Corporate-owned practices (which increasingly are the only thing you can find if you want to use your preposterously overpriced insurance) hire non-physicians to do what properly is physician’s work because the non-physicians are more readily available, are significantly cheaper and allow vastly increased financial leverage and a concomitant increase in profit. People say that their non-physician “provider” is great and will refer them if anything is “serious.”  The problem is that few patients have even the slightest ability to determine how “serious” their condition is; regardless of their misplaced self confidence, non-physicians lack the training to avoid mistakes that a physician would catch. Given the rate of physician error, it is terrifying to think how much non-physicians may be missing.[b] I am alive today because a physician noticed a deadly skin cancer when I was in for something else entirely. I have very little confidence that a non-physician would have caught that.[/b] [/quote]

I caught my husband’s melanoma, so pretty sure an NP could as well.[/quote]

The people who don't like "anyone except a full MD" seem to not realize that [b]you can deal with a bad MD just as much as a Bad NP/BadPA/Bad whatever other medical staff.  [/b]

By and large, NP/PA take more time and get to know their patients and often provide a higher level of care, freeing up time for the full MD to see the patients with more urgent cases, who need surgery, etc.

A NP/PA can do my yearly exam/gyn exam.  If they see any issues, they will always get me in to see the Gyn for follow up.  But there is typically no need to see a Gyn if you don't have issues.  Seeing the same NP/PA each year means they get to know you, know your minor issues and can send you for more tests/refer to MD as needed.  
I have never dealt with a PA/NP that isn't highly qualified.  OTOH, I've dealt with a few incompetent MDs, and plenty with no bedside manner and no recollection of me from my last visit even if it was 4 weeks ago, which is almost as bad as incompetent[/quote]

(new poster) No. I am a specialist MD and routinely get patients who have received poor/inappropriate care from mid levels - way more than those who have gotten poor care from MDs. In my professional discussion groups, we routinely trade horror stories about mid level overmedication, dangerous medication interactions that were overlooked, grossly inappropriate dosing, missed diagnoses that were obvious, and overall quite a lot of intervention that led to more harm than if they had done nothing at all. It's not like these things never happen with an MD, but it's orders of magnitude less frequent. The scope creep is scary to me not just as a provider, but as a patient like everyone else. [/quote]

Another buzzword:  “mid-level.”  Where did that come from?  What’s “entry level?”  The receptionist?[/quote]

Be very leery of seeing any PA's that graduated from the UMES program.  It was actually discontinued for a number of years
due to scandal.

Mom's experience. She is usually prescribed 250 mg cipro twice a day for UTI.  The UMES PA grad prescribed 1000 mg twice a day for UTI.  Mom had severe psychosis from this over prescribing.  The PA was affiliated with her regular PCP so the PA had access to her dosing records.[/quote]

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