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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]I agree that NPs are the future. It won’t be worth it for doctors do to so much training. The problem is lack of standardization of NP training but it seems that most patients don’t care - they just want someone to “listen” vs actual experience rotating through various divisions. For example, to become a primary care doctor, I still have to do three years post medical school rotating through the icus, ED, hepatology, oncology, primary care, women’s health, cardiology, etc. the idea is that I should have seen all these things and proved competence. There are no strict guidelines for NPs/PAs. They finish in 2 years and could get a job in outpatient obesity medicine then switch to the icu with little training and no one cares. [/quote]

Is all that training really necessary to order a strep test, see the results and prescribe an antibiotic? How about to see a mole and refer a patient to a dermatologist? So much of what a PCP does, especially for healthy patients, is routine care that does not need perfect undergraduate grades, three years of medical school, three years of residency, and a fellowship [/quote]

I think it may be bias on a patient’s end to think this is all a pcp does. In my practice, I see really sick patients with many comorbities. For example, a cancer survivor with diabetes and hypertension. I need to know what kinds of chemo my patient has been on since there will be life long risks associated. I also need to know all the diabetes drugs and their interactions with her other meds. I need to know that she is more likely to have recurrence of cancer and also potential blood clots, PE etc. I need to understand that if she walks into my office with low blood pressure and tachycardia that it may be sepsis. All of these things I learned with brute repetition in residency - caring for patients who are super sick day in and day out. Before you say anything most specialist will not handle a cancer patients diabetes and hypertension - esp if they are a survivor and in remission. That’s in primary care land. Just an example. [/quote]

Those patients probably nee you. There is no reason that a healthy family needs your level of expertise.  [/quote]

Yes and that’s what most MDs see. There are many many many patients that fall into this category. Not sure who will take care of them in the future. I feel bad for the inevitable push to have NPs and PAs take care of these patients with little training and half the salary but with no one going into primary care that will be the situation. [/quote]

You could pay PCPs like specialists, but I don't think most people would accept what that would do to their insurance rates [/quote]

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