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We need a different kind of system for medical care. It has to be more like the dentist if we ever want to reduce costs on this side of the triangle. The MD sho

We need a different kind of system for medical care. It has to be more like the dentist if we ever want to reduce costs on this side of the triangle. The MD should only see patients when absolutely necessary, the rest of the time a RN or CNA is completely fine. By having lower levels provide most of the care, we can change the economics and actually provide more care to people who don't get it now. A lot of this is of our own making. Trying to get into a dermatologist for a skin condition is really hard. They are all booked up on cosmetic customers that pay more and increase profits. We want urgent cares on every corner because it is more convenient to our schedule than scheduling with our primary. All this duplication of facilities and staffing have consequences. Care from lower level staff is coming more and more rapidly, it is the only way to somewhat limit costs against the bloat on the other side. For that, we really need reference based pricing but don't forget that one person's waste is another person's salary.

908B64B197 5y ago
> The MD should only see patients when absolutely necessary, the rest of the time a RN or CNA is completely fine Today there are nurse practitioners with a four year undergrad in Nursing, 2-3 years of experience in hospital, and a 3 year full time masters degree (where fall and winter are spent in classroom and the summer term in the field). We are rapidly approaching the years of (relevant) schooling of an MD in family medicine...
- nacho2100 5y ago
  This would be more believable position if nurse practitioners have ever been able to demonstrate equivalent medical knowledge to physicians, but when the best trained NPs were given the chance to take a watered down version of Step 3 which has a 97% MD pass rate with 1-3 weeks of casual studying, only 40% passed. The reality is an equivalent number of years does not equate the quality and rigor of the family medicine which is argueably one of the hardest specialties. This is notwithstanding the explosion of NP diploma mills with classes on lobbying and health care disparities who take any applicant with a pulse.
  - 908B64B197 5y ago
    > but when the best trained NPs were given the chance to take a watered down version of Step 3 which has a 97% MD pass rate with 1-3 weeks of casual studying, only 40% passed. Citation needed? > This is notwithstanding the explosion of NP diploma mills There's no standardization yet for NPs. I've seen short, one year programs as well as 3+ years ones. That's indeed an issue they must tackle.

908B64B197 5y ago

> The MD should only see patients when absolutely necessary, the rest of the time a RN or CNA is completely fine Today there are nurse practitioners with a four year undergrad in Nursing, 2-3 years of experience in hospital, and a 3 year full time masters degree (where fall and winter are spent in classroom and the summer term in the field). We are rapidly approaching the years of (relevant) schooling of an MD in family medicine...

nacho2100 5y ago
This would be more believable position if nurse practitioners have ever been able to demonstrate equivalent medical knowledge to physicians, but when the best trained NPs were given the chance to take a watered down version of Step 3 which has a 97% MD pass rate with 1-3 weeks of casual studying, only 40% passed. The reality is an equivalent number of years does not equate the quality and rigor of the family medicine which is argueably one of the hardest specialties. This is notwithstanding the explosion of NP diploma mills with classes on lobbying and health care disparities who take any applicant with a pulse.
- 908B64B197 5y ago
  > but when the best trained NPs were given the chance to take a watered down version of Step 3 which has a 97% MD pass rate with 1-3 weeks of casual studying, only 40% passed. Citation needed? > This is notwithstanding the explosion of NP diploma mills There's no standardization yet for NPs. I've seen short, one year programs as well as 3+ years ones. That's indeed an issue they must tackle.