Don’t Dummy Down, Smarten Up
I’ve said it a million times and I’ll say it again, you can’t fake it until you make it in medicine. Medicine is just too complex. U.S. medicine is a whorehouse in which corporate dimwits reside. The financially-driven, volume-based, dummied down, nursing-led mutation they have perpetuated in medicine is destined to fail. When one allows individuals untrained in medicine to practice it, don’t be surprised when the “care” amounts to that a layperson would provide. Medicine requires expertise. The s**t we see today is not expertise–it’s parody. Authentic medicine will not thrive under such conditions. Red flags exist all over medicine that demonstrate the deterioration of a professional discipline that once had standards. Legislators, the AANP and traitor trash docs are so eager to enable NPs, who are not qualified to practice medicine, to practice “at the top of their license” such that the preposterous s**t below occurs.
What is this s**t? This nonsense is in a patient’s record. A MEDICO-LEGAL DOCUMENT. The patient was sent to a neurologist because a NP who has no understanding of medical terminology(or medicine) confused “multiple sclerotic densities” seen on bone with the neurologic disorder multiple sclerosis. Now a neurologist’s valuable time is wasted, the patient’s time and money is wasted and the patient made a wasted trip. And all of this idiocy is documented in the patient’s medical record forever. Keep in mind that when the errors of the NPs ways are pointed out, they and their virtue-signaling physician saviors, legislators and the corporate mob like to point out docs make mistakes also. Well guess what? Docs DO NOT make mistakes like this. If I saw this s**t written in a patient’s record by a physician I would report their a** to the medical board for perpetrating a physician.
More red flags that a NP has attended a degree mill is when they ask basic fundamental questions that should have been learned as part of a legitimate education. Show me in this following example where an advanced education is demonstrated. Please.
Let me remind you of the NP crap studies that claim their management of diabetes is the same or better than actual primary care physicians. My a**. Newbie or not, the question posed by this NP clearly emphasizes that she received no education at all, let alone an advanced one. Diabetes Mellitus is bread and butter primary care. She was bamboozled by her so-called “program”. Hoodwinked. Scammed. Add to that her incomplete, lousy presentation and it is not difficult to conclude that this NP is not “prepared to provide safe, high quality, evidence-based care from the point of graduation” as intimated by Sophia Thomas, the former president of the AANP.
How does one graduate as a NP, get licensed and hired to work in a hospital or clinic and have no idea how to write orders? How? Two ways…attend a degree mill and apply to a job where vetting is non-existent(ie: hospitals run by corporate pimps), that’s how. This absurdity is an everyday occurrence. NPs too ashamed or egotistical to ask physicians for help lest we know how much knowledge they truly lack, resort to their forums where the blind lead the blind. But the deficits show up anyway, in patient mismanagement and the aforementioned documentation. Because, once again, you can’t fake that s**t. Now imagine a newly graduated Family Medicine or Internal Medicine resident physician asking the same question as this NP–how long do you think he/she would last in that job? Yet NPs can fill the physician gap. Ok.
Listen folks, education matters in medicine. There are no “reasonable” facsimiles that make it appropriate to use an insufficient education to practice on human beings like lab rats. There should be no “learning as you go” with no oversight by those trained in medicine. How does one refer a complex patient if one doesn’t know one is looking at a complex patient because the issue is simplified by a limited education? How did we get to this place where the ridiculous examples above are condoned? This is not progression of medicine, this is regression and a travesty of education. Just shameful. For a country that supposedly has the best medicine in the world, this medical illiteracy is mortifying. No other country deals with this kind of asinine s**t.
Patients are screwed. So are many of us health care workers who become patients in this hellcare system. Better stock up on the lube and Preparation H folks, it’s going to be a rough ride.
PS- I recently received a nasty letter from a community NP ordering me to treat sinusitis in a manner different than my plan and that of ENT, which matched. The NP wanted ongoing gentamicin sinus rinses 160 mg. twice a day to prevent infection, but could not write for it “for insurance reasons.” However, I am EXPECTED TO, and the patient was promised that I WILL. In writing, copy to the patient.
Unbelievable.
Any way you could post it with identifying info blacked out?
I purposely redact identifying info(other than the name of the forum) because it distracts from the point. The focus should not be on an individual NP or PA, but a system that enables this nonsense to occur over and over and over again.
It’s time to retire Steve’O if you can. I had an N.P. who worked with me in the office and it was a good collaborating relationship. The N.P.’s in our practice didn’t do hospital work or take call. If something tough came in the office, my N.P. grabbed me as soon as I came out of a room. The N.P.’s were “supposed” to get straight forward patients but sometimes that wasn’t the case.
Debbie made some good pickups that resulted in me doing direct admissions! Worked well for me. She retired earlier than me as she was older and “the administration” didn’t assign me another N.P. as I was getting close to retirement too. I will have to say that my “assigned” N.P.’s career as she told me occurred in a very roundabout fashion and she had an incredible amount of experience in specialized nursing and “life” before she became an N.P. When Deb came up to me in the office and said, “Doc, I have this patient.” I’d think oh shi# now I gotta really think on this one! Sometimes I could sort it out, sometimes I had to admit to the hospital which is fine. Patient got what they needed. I am on the side to nix independent practice of N.P.’s. My collaborating N.P. Debbie told me she would never want to be independent without a collaborating Doctor. Kurt
Say what?
I am reading The Heart of Caring by Mark Vonnegut MD, a retired Pedes who recalls the days long forgotten. Rose-colored memories aside, what we have now is an abject failure, and soon will be forgotten completely in the eternal Now.
EVERYTHING IS A BUSINESS MODEL… MEDICINE, GOVERNMENT, WAR, INSURANCE.. EVERYTHING HAS A BOTTOM LINE.. HOW MANY OF YOU WILL PUT YOUR LIFE,YOUR FORTUNE AND SACRED HONOR ON THE LINE TO CHANGE IT……. crickets not heard,complete silence…..YOUR CHOICE….
Funny how the local dermatology clinic has no dermatologist on site……I guess PA’s can do that kind of work.
“Docs DO NOT make mistakes like this. If I saw this s**t written in a patient’s record by a physician I would report their a** to the medical board for perpetrating a physician.”
Gold lol…
Docs need to stop enabling them though. So many docs work with them and don’t establish boundaries or use them for nearly all aspects. Urologists are now happy to have their mid levels doing cystos… we’ll how they feel about that and its resulting progression a decade from now.
NP schools are online and consist mostly of sociology type courses writing papers with virtually no science education. The clinical is finding a few private practice doctors to sign papers that they observed for a grand total of 12 weeks with no responsibility and often 20 hours a week attendance. Then in independent practice they perform the need of… injecting Botox and fillers from their house.
At the same time our hospitals insist we take call for no pay to come in when the ER NP does not want to sew a laceration or asks the patient if they would prefer a specialist ( of course the HMO pays the same $100)
The numbers of nurses going online for NP are one major factor for the nursing shortage. And the Pandemic money first thrown at NY has created a cascade of traveling nurses making 100 to 200k a year.
Why go to medical school?
I wish I could say that I was confident that real doctoring would drive out bad doctoring driven by NP’s without Physician oversight. But I rather think it will go the other way, sort of like the old adage that bad money drives out good.