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[quote=Anonymous][quote=Anonymous][quote=Anonymous]My training was explicit that you had to see tens of thousands of normal to recognize abnormal reliably. Rashes don't often look textbook, and there is so much variation in presentation of the same diagnosis.

Without that large clinical database in your own mind, you can't reliably tell when to worry. Anemia that is not microcytic and hypochromic, or that doesn't respond as expected to treatment (as per PP)? Dig further. On the other hand, you don't order labs or antifungal treatment for pityriasis rosea when you can recognize it, even on the many varieties of skin type.

NPs can be fantastic. Old school NPs with many bedside years under the belt, or NPs who are well-trained in a narrow scope with good oversight (e.g., L&D) are more likely to be fantastic than others.

And you still need to see tens of thousands of normal before you can reliably pick out abnormal.[/quote]

So after the “new-school” NPs will be OK once they have enough experience?  A lot of us have been treated by super-new medical residents (MDs) whose inexperience was palpable, so I would only be worried if the NP was also unseasoned.[/quote]

The medical school model is built to accommodate for new residents. Interns are supervised by a senior resident who is supervised by a fellow or an attending. There are required conferences. Required exams throughout. Board exams. And frequent check ins to make sure you are on track.

an NP/PA can just graduate and start prescribing. It’s very alarming. I was working with a new Doctor in Nursing. She did have several years as a nurse and just got her PhD and now she can prescribe independently. She admitted she was scared and was nervous to even prescribe an aspirin. Well I would be too! She didn’t have any residency to help her slowly build independence. How is that okay? How would she know when to hold aspirin with some patients and when to start aspirin for secondary prevention without a rigorous training? And all these organizations don’t care about you or your health! Np and pa are cheaper. They finish faster and can prescribe immediately so you’ll see more and more of them.[/quote]

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