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[quote=Anonymous][quote=Anonymous]Nurses like becoming NPs because it pays better and they have more freedom (can prescribe meds).

I have had good and bad experiences with NPs. In theory they improve the system by handling cases that might be too simple or straightforward for a doctor. And they do generally get to spend more time with patients, making them a good option for a PCP (PCN?) where not being rushed can be helpful.

However I have had very negative experiences with NP specialists. I do not feel the training fir their specialty is sufficient and they can have unearned confidence, especially in diagnosis. I've had a gyn NP miss major symptoms, for instance.

There is a reason medical training for fir doctors is as long as it is. It's inconvenient, for them and fir patients, because it leads to doctor shortages. But I'm not convinced replacing a bunch of MD roles with NPs is going to solve things, especially with the current fairly low requirements for training and school to get specialized NP licenses.[/quote]

Doctor(Hospital Medicine) here who works and supervises both PAs and NPs on a daily basis. I find that for new grads PA&gt;&gt;&gt;NPs.  Pa’s are better trained. I love my NPs who were nurses for many years before becoming an NP, but that is not the norm anymore. Most go through straight to NP school and have the bare minimum clinical hours to pass.

As for the comment on Midlevels in specialists offices. I hate when I refer a patient to a specialist and they get their initial consultation with a midlevel. I know more medicine than that midlevel especially since they don’t have to train in that specialty before getting a job. They are essentially learning on the Job. They can be in the ER for 6 months then decide they want to do derm and just switch. Then switch to GI. There is no mandated training, no certification exams. Why would I trust them with my complex patient who needs a specialist. Their role should be easy followups or post-op visits, not diagnosing complex patients. Those poorly trained often diagnose with a shotgun approach, over ordering tests and labs until something hits. This is because they don’t have the same foundational knowledge a physician has to know which tests to order. It increases the cost of doing medicine and is frustrating to patients. [/quote]

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