4 ms·

Easy to say that, harder to live it. Would you willingly choose to receive treatment from a less trained, less accurate NP? I wouldn’t, even if I had to wait lo

Easy to say that, harder to live it. Would you willingly choose to receive treatment from a less trained, less accurate NP? I wouldn’t, even if I had to wait longer.

newyankee 5y ago
People without any affordable alternative will, and will be the first target markets.
ZeroGravitas 5y ago
Why the assumption that they're worse? If the root cause of the problem is monopoly, then this is exactly analogous to the question of established monopolist vs startup. "No one ever got fired for choosing <current monopolist>" is fine if you're playing it safe but many people don't have that option and find, sometimes to their surprise, that the cheaper option is also better, due to the different incentives in play.
- poirot2 5y ago
  This is an ill informed take. It’s common when someone doesn’t know what X role does from the outside to think they are interchangeable. Medical school takes candidates that are already on average much stronger than NP trainees and then trains them more rigorously. Further, the specific training pathway after medical/ nursing school is v different. NPs are trained in seeing ‘textbook’ or standard cases and a flowchart of management for them. Which is great if you are one of them. And since most people present ‘typically’ for that clinic you can use NPs to filter through people and get them seem quickly/ cheaply. However, they don’t have the toolkit to handle greater complexity that is outside the flowchart and don’t generally know how recognise when a standard flowchart approach to management shouldn’t apply. It’s rather tough to explain in lay terms other than via analogy - you’ve basically said all software engineers should be replaced by data analysts.
  - ZeroGravitas 5y ago
    No, it's like saying all programmers should be replaced by certified programmers who are all from good families and have 10 years of intense training at top schools and massive debt. You wouldn't trust some young immigrant or a long haired hippy kid who dropped out of college and started a business in his garage to provide your tech would you? Computers are complicated, we can't let amateurs in hoodies start doing things without some central control.
    - lotsofpulp 5y ago
      NP/PA education is far less rigorous And requires far less hours than MD. Many more NP/PA schools have far more lax standards, and are probably better called diploma mills than MD schools. It is all probabilities, and I would rather bet on an MD. At least compared to the current incarnation of NP/PA.
      - sokoloff 5y ago
        Likewise: Boot camps and self-teaching are far less rigorous than CS degree programs, which I think is GP’s point.
      - leereeves 5y ago
        MD education in the US takes so long because students are required to spend four of those eight years studying something other than medicine. Nurses actually study medicine as undergraduates before graduate NP education, so one could argue that NPs have more education in medicine.
        lotsofpulp 5y ago
        The problem of NP/PA is not in the design or scalar length of education. It is in the credentialing. MDs have to take MCAT and step exams, which I know weed out many people. From my understanding, there is a relatively very low barrier to entry for NP/PA. As a side note, the physician credentialing process of the US is far too long.
renewiltord 5y ago
That’s the wrong question. Would you rather suffer for want of a doctor or see someone else? We already know the answer. People seek them where they can get them. WebMD. Google. Fish mox on Amazon. Self-treatment is rife. If I had the choice I’d go to a doctor (and I always have the choice - my parents and cousins are surgeons). But I “go to the doctor” for something as mild as a contusion on my knee or the suggestion of sniffles or if I wake up with my eyes feeling a bit dry. The people who don’t have the choice don’t call the doctor when they can’t even get out of bed. It’s about all the people without a choice.

Easy to say that, harder to live it. Would you willingly choose to receive treatment from a less trained, less accurate NP? I wouldn’t, even if I had to wait longer.

newyankee 5y ago

People without any affordable alternative will, and will be the first target markets.

ZeroGravitas 5y ago

Why the assumption that they're worse? If the root cause of the problem is monopoly, then this is exactly analogous to the question of established monopolist vs startup. "No one ever got fired for choosing <current monopolist>" is fine if you're playing it safe but many people don't have that option and find, sometimes to their surprise, that the cheaper option is also better, due to the different incentives in play.

poirot2 5y ago
This is an ill informed take. It’s common when someone doesn’t know what X role does from the outside to think they are interchangeable. Medical school takes candidates that are already on average much stronger than NP trainees and then trains them more rigorously. Further, the specific training pathway after medical/ nursing school is v different. NPs are trained in seeing ‘textbook’ or standard cases and a flowchart of management for them. Which is great if you are one of them. And since most people present ‘typically’ for that clinic you can use NPs to filter through people and get them seem quickly/ cheaply. However, they don’t have the toolkit to handle greater complexity that is outside the flowchart and don’t generally know how recognise when a standard flowchart approach to management shouldn’t apply. It’s rather tough to explain in lay terms other than via analogy - you’ve basically said all software engineers should be replaced by data analysts.
- ZeroGravitas 5y ago
  No, it's like saying all programmers should be replaced by certified programmers who are all from good families and have 10 years of intense training at top schools and massive debt. You wouldn't trust some young immigrant or a long haired hippy kid who dropped out of college and started a business in his garage to provide your tech would you? Computers are complicated, we can't let amateurs in hoodies start doing things without some central control.
  - lotsofpulp 5y ago
    NP/PA education is far less rigorous And requires far less hours than MD. Many more NP/PA schools have far more lax standards, and are probably better called diploma mills than MD schools. It is all probabilities, and I would rather bet on an MD. At least compared to the current incarnation of NP/PA.
    - sokoloff 5y ago
      Likewise: Boot camps and self-teaching are far less rigorous than CS degree programs, which I think is GP’s point.
    - leereeves 5y ago
      MD education in the US takes so long because students are required to spend four of those eight years studying something other than medicine. Nurses actually study medicine as undergraduates before graduate NP education, so one could argue that NPs have more education in medicine.
      - lotsofpulp 5y ago
        The problem of NP/PA is not in the design or scalar length of education. It is in the credentialing. MDs have to take MCAT and step exams, which I know weed out many people. From my understanding, there is a relatively very low barrier to entry for NP/PA. As a side note, the physician credentialing process of the US is far too long.

renewiltord 5y ago

That’s the wrong question. Would you rather suffer for want of a doctor or see someone else? We already know the answer. People seek them where they can get them. WebMD. Google. Fish mox on Amazon. Self-treatment is rife. If I had the choice I’d go to a doctor (and I always have the choice - my parents and cousins are surgeons). But I “go to the doctor” for something as mild as a contusion on my knee or the suggestion of sniffles or if I wake up with my eyes feeling a bit dry. The people who don’t have the choice don’t call the doctor when they can’t even get out of bed. It’s about all the people without a choice.