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11 thoughts on “Who Did This AANP Meme?”
For years I was in healthcare (nutrition, chiropractic) and I wanted so badly to be a physician as my thirst for knowledge and new skills has never ceased.
So at 58 I went to medical school. So should any DC, NP, PT or others who want to legitimately actually practice medicine.
Now THAT sounds like a legitimate campaign for physicians!
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Will we need a Flexner Report for Nurse Practitioner training programs?
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My personal experience as a patient is that they are not. Professionally I’ve worked with AAPA and find their view on collaboration rather than competition with physicians much more appropriate.
On the other hand, my last primary care physician, an internist, said that an NP could do about 90% of the job. The key difference is that other 10% and knowing the difference.
I wonder if there are any double blinded studies comparing treatment by FM/IM MDs/DOs vs. NPs?
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PS: A warning: Whether DO, MD, NP, RN, BSN – If you’re feeling dehumanized, burnt-out, exhausted and depersonalized by your job, if you can’t tell whether you’re just some sort of weird inhuman mechanized android, it’s because….you are. Real humans don’t fear they are actually droids. Only androids do. Congratulations, welcome to the Twilight Zone
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Hey give credit where credit is due. Karl Marx was, well, WRONG! about a lot of what he thought and wrote, but he hit the nail on the head with the concept of “commodification of labor.”
Basically, the idea is this – wherever possible, a wall has to be erected by people who invest for a living, between the corporation and the people who work for a living. Competition with the corporation is frowned upon. (This shows that what we call Capitalism, and real Ayn Rand / Adam Smith capitalism, are nearly opposites.)
In medicine, the model had been the single practitioner or small group practice existing as a local business entity, and it was clear that this is something that the corporations had to smash. Individual doctors and groups of doctors could create these self-sustaining entities that provided healthcare to a community, often partnered with a local hospital or two, in a rogue, unregulated, uncontrolled response to that communities needs. What if everything worked like that? Such things are anti-Soviet! (Sorry, I’m getting too honest.)
A machine, a pseudo-doctor had to be created which could not sustain itself without corporate authority, and could not combine into these threats called “Private Practice.”Voila!” A nurse practitioner. With the heart of a nurse, but without the ability to survive without corporate control like a doctor! Nah, can’t put that on the stationery.
Some Private Practices work with Nurse Practitioners as employees, and even as partners! Some of the real Left-o Pinko partnership of all employees in proportional shares! Those were more common than we’re allowed to remember – profit-sharing, stand-alone practices.
Fortunately, MediCorp Inc., has crushed most of these sorts of heresies out of existence with a combination of Regulation, Insurance Cartels, and endless advertising about how Good Is Bad! In a generation, a person trying solo practice will be treated with all the respect and support as a rifleman seen on a college tower.
That is the problem with Nurse Practitioners. It is not the Nurse Practitioners. It is that the current definition, like that of Prescribing Pharmacists (they’re here!!) is a corporate-made concept, an artificial life-support pod for a totally controlled worker who can’t survive when the hatch is open.
We have prescribing PharmD’s. We will soon have independently prescribing EMT’s. They’ve become profitable as the corporation chips away at the Liability Burden.
Wal-Mart doesn’t have liability for what they sell. Doctors have career-ending liability for what they do. The close we get to Wal-Med, the more the liability is dumped onto the consumer, and the safer the industry becomes – for the corporation.
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Thank you for such a thoughtful response. It is unfortunate that we have been placed in a position of physicians vs NP’s. AANP and PPP both tend to take extreme positions. As you point out, NP’s are not the only likely inappropriate expansions of role. The start of NP programs was to address the usual, the typical. And to eagerly work colleague-ally with physicians when a patient didn’t fit that or didn’t respond as expected. As someone else stated, NP’s can appropriately address a large portion of primary care issues. Most of us who’ve been around more than 15 years grew into the role. But healthcare has changed. PCP’s no longer see their hospitalized patients, “hospitalists” do. Then corporations saw a way to save money – they created hospitalist NP’s. Almost by definition, nothing is typical about an acutely (perhaps even multi-system) ill hospitalized pt. This NP feels that utilization, which has now been widely embraced, is totally inappropriate. But it created a demand for NP’s. And educational institutions saw a way to make money. Now pre-RN’s have as their goal being NP’s, and they are welcomed by schools as long as they pay the tuition. Yes, we do need a Flexner Report for nursing education. Somewhere along the way, generational expectations changed, too. Teamwork outside a hierarchical structure has become a foreign concept. We find ourselves fighting about being independent – no provider in health care is independent. Collaboration (a wonderful safeguard we all use) or supervision (one party responsible for another on a daily basis) is written into legal regulations as a useless paper exercise that does nothing to protect patients while placing legal burdens on both NP and physician providers who are party to these agreements. The states adopting full practice authority for NP’s are removing those paperwork exercises. Hopefully the NP profession will address its internal educational issues in far less than the over 100 years it took US medicine to. All of healthcare needs to look at the big picture and try to help move away from the overabundance of healthcare institution/insurance company control (to say nothing of government interference) in how we can provide human care, including the highly technical and specialized options physicians now have available.
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I’m starting an online diplomate for Society of Nurse Independent Practitoners of Surgery (SNIPS). It comes with a free Appy App that has online specialty upgrades in case you need Neuro, Thoracic, Trauma, etc. How can you disagree if it’s never been tried?
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Ouch!!!!
The hardliners are most assuredly NOT Agounf to find this at all amusing!! I can think of a few off the top of my head!
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Horrific… think of all the patients who have suffered and are suffering from this fraud.
Only when the body count is high enough with VIP cases will the public begin to realize they were lied to by this organization (AANP).
Hopefully patients are beginning to educate themselves and learn better.
NP education is non-standardized, may be done online, and requires less than 3 percent of the clinical hours needed for a family medicine physician. NPs provide a lower quality of care at a higher cost to patients.
And for a rebuttal to the bad science (short follow-ups, low power, bias, etc.) studies declaring NP equality see:
McCleery E, Christensen V, Peterson K, et al. Evidence Brief: The Quality of Care Provided
by Advanced Practice Nurses. 2014 Sep. In: VA Evidence-based Synthesis Program
Evidence Briefs [Internet]. Washington (DC): Department of Veterans Affairs (US); 2011-.
“Recent publications promoting over-riding state scope-of-practice laws argue
that a large body of evidence shows APRNs working independently provide the
same quality of care as medical doctors. We found scarce long-term evidence to
justify this position.”
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Big ANP is a fraud and a disservice to honest NP’s. As for the phonies who want to play doctor…
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Truth hurts!
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For years I was in healthcare (nutrition, chiropractic) and I wanted so badly to be a physician as my thirst for knowledge and new skills has never ceased.
So at 58 I went to medical school. So should any DC, NP, PT or others who want to legitimately actually practice medicine.
Now THAT sounds like a legitimate campaign for physicians!
Will we need a Flexner Report for Nurse Practitioner training programs?
My personal experience as a patient is that they are not. Professionally I’ve worked with AAPA and find their view on collaboration rather than competition with physicians much more appropriate.
On the other hand, my last primary care physician, an internist, said that an NP could do about 90% of the job. The key difference is that other 10% and knowing the difference.
I wonder if there are any double blinded studies comparing treatment by FM/IM MDs/DOs vs. NPs?
PS: A warning: Whether DO, MD, NP, RN, BSN – If you’re feeling dehumanized, burnt-out, exhausted and depersonalized by your job, if you can’t tell whether you’re just some sort of weird inhuman mechanized android, it’s because….you are. Real humans don’t fear they are actually droids. Only androids do. Congratulations, welcome to the Twilight Zone
Hey give credit where credit is due. Karl Marx was, well, WRONG! about a lot of what he thought and wrote, but he hit the nail on the head with the concept of “commodification of labor.”
Basically, the idea is this – wherever possible, a wall has to be erected by people who invest for a living, between the corporation and the people who work for a living. Competition with the corporation is frowned upon. (This shows that what we call Capitalism, and real Ayn Rand / Adam Smith capitalism, are nearly opposites.)
In medicine, the model had been the single practitioner or small group practice existing as a local business entity, and it was clear that this is something that the corporations had to smash. Individual doctors and groups of doctors could create these self-sustaining entities that provided healthcare to a community, often partnered with a local hospital or two, in a rogue, unregulated, uncontrolled response to that communities needs. What if everything worked like that? Such things are anti-Soviet! (Sorry, I’m getting too honest.)
A machine, a pseudo-doctor had to be created which could not sustain itself without corporate authority, and could not combine into these threats called “Private Practice.”Voila!” A nurse practitioner. With the heart of a nurse, but without the ability to survive without corporate control like a doctor! Nah, can’t put that on the stationery.
Some Private Practices work with Nurse Practitioners as employees, and even as partners! Some of the real Left-o Pinko partnership of all employees in proportional shares! Those were more common than we’re allowed to remember – profit-sharing, stand-alone practices.
Fortunately, MediCorp Inc., has crushed most of these sorts of heresies out of existence with a combination of Regulation, Insurance Cartels, and endless advertising about how Good Is Bad! In a generation, a person trying solo practice will be treated with all the respect and support as a rifleman seen on a college tower.
That is the problem with Nurse Practitioners. It is not the Nurse Practitioners. It is that the current definition, like that of Prescribing Pharmacists (they’re here!!) is a corporate-made concept, an artificial life-support pod for a totally controlled worker who can’t survive when the hatch is open.
We have prescribing PharmD’s. We will soon have independently prescribing EMT’s. They’ve become profitable as the corporation chips away at the Liability Burden.
Wal-Mart doesn’t have liability for what they sell. Doctors have career-ending liability for what they do. The close we get to Wal-Med, the more the liability is dumped onto the consumer, and the safer the industry becomes – for the corporation.
Thank you for such a thoughtful response. It is unfortunate that we have been placed in a position of physicians vs NP’s. AANP and PPP both tend to take extreme positions. As you point out, NP’s are not the only likely inappropriate expansions of role. The start of NP programs was to address the usual, the typical. And to eagerly work colleague-ally with physicians when a patient didn’t fit that or didn’t respond as expected. As someone else stated, NP’s can appropriately address a large portion of primary care issues. Most of us who’ve been around more than 15 years grew into the role. But healthcare has changed. PCP’s no longer see their hospitalized patients, “hospitalists” do. Then corporations saw a way to save money – they created hospitalist NP’s. Almost by definition, nothing is typical about an acutely (perhaps even multi-system) ill hospitalized pt. This NP feels that utilization, which has now been widely embraced, is totally inappropriate. But it created a demand for NP’s. And educational institutions saw a way to make money. Now pre-RN’s have as their goal being NP’s, and they are welcomed by schools as long as they pay the tuition. Yes, we do need a Flexner Report for nursing education. Somewhere along the way, generational expectations changed, too. Teamwork outside a hierarchical structure has become a foreign concept. We find ourselves fighting about being independent – no provider in health care is independent. Collaboration (a wonderful safeguard we all use) or supervision (one party responsible for another on a daily basis) is written into legal regulations as a useless paper exercise that does nothing to protect patients while placing legal burdens on both NP and physician providers who are party to these agreements. The states adopting full practice authority for NP’s are removing those paperwork exercises. Hopefully the NP profession will address its internal educational issues in far less than the over 100 years it took US medicine to. All of healthcare needs to look at the big picture and try to help move away from the overabundance of healthcare institution/insurance company control (to say nothing of government interference) in how we can provide human care, including the highly technical and specialized options physicians now have available.
I’m starting an online diplomate for Society of Nurse Independent Practitoners of Surgery (SNIPS). It comes with a free Appy App that has online specialty upgrades in case you need Neuro, Thoracic, Trauma, etc. How can you disagree if it’s never been tried?
Ouch!!!!
The hardliners are most assuredly NOT Agounf to find this at all amusing!! I can think of a few off the top of my head!
Horrific… think of all the patients who have suffered and are suffering from this fraud.
Only when the body count is high enough with VIP cases will the public begin to realize they were lied to by this organization (AANP).
Hopefully patients are beginning to educate themselves and learn better.
NP education is non-standardized, may be done online, and requires less than 3 percent of the clinical hours needed for a family medicine physician. NPs provide a lower quality of care at a higher cost to patients.
Learn more about the education gap. See:
https://www.tafp.org/Media/Default/Downloads/advocacy/scope-education.pdf
——
And for a rebuttal to the bad science (short follow-ups, low power, bias, etc.) studies declaring NP equality see:
McCleery E, Christensen V, Peterson K, et al. Evidence Brief: The Quality of Care Provided
by Advanced Practice Nurses. 2014 Sep. In: VA Evidence-based Synthesis Program
Evidence Briefs [Internet]. Washington (DC): Department of Veterans Affairs (US); 2011-.
Available from: http://www.ncbi.nlm.nih.gov/books/NBK384613/
“Recent publications promoting over-riding state scope-of-practice laws argue
that a large body of evidence shows APRNs working independently provide the
same quality of care as medical doctors. We found scarce long-term evidence to
justify this position.”
Big ANP is a fraud and a disservice to honest NP’s. As for the phonies who want to play doctor…
Truth hurts!