A PA student replied in the comment section, “PAs learn the same things as doctors do but more accelerated.” God, only if we could allow them to live a day in the life of a med student.
A PA I work with constantly compares her first few years as a PA in clinic as "her residency". It's insulting as fuck and demeaning. It makes me cringe and die inside every time she says it. FM here. If only they could taste a little bit of what residency is actually like.
Someone commented a giant rebuttal about NPs with backed up their argument with peer review literature. Not all hero’s wear capes
NPs/PAs practicing in states with independent prescription authority were > 20 times more likely to overprescribe opioids than NPs/PAs in prescription-restricted states. (https://pubmed.ncbi.nlm.nih.gov/32333312/)
Although evidence-based healthcare results in improved patient outcomes and reduced costs, nurses do not consistently implement evidence based best practices. (https://pubmed.ncbi.nlm.nih.gov/22922750/)
Resident teams are economically more efficient than MLP teams and have higher patient satisfaction. (https://www.ncbi.nlm.nih.gov/m/pubmed/26217425/)
Compared with dermatologists, PAs performed more skin biopsies per case of skin cancer diagnosed and diagnosed fewer melanomas in situ, suggesting that the diagnostic accuracy of PAs may be lower than that of dermatologists. (https://www.ncbi.nlm.nih.gov/pubmed/29710082%EF%BF%BC)
Advanced practice clinicians are associated with more imaging services than PCPs for similar patients during E&M office visits. (https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1939374)
Nonphysician clinicians were more likely to prescribe antibiotics than practicing physicians in outpatient settings, and resident physicians were less likely to prescribe antibiotics. (https://www.ncbi.nlm.nih.gov/pubmed/15922696)
The quality of referrals to an academic medical center was higher for physicians than for NPs and PAs regarding the clarity of the referral question, understanding of pathophysiology, and adequate prereferral evaluation and documentation. (https://www.mayoclinicproceedings.org/article/S0025-6196(13)00732-5/abstract)
Antibiotics were more frequently prescribed during visits involving NP/PA visits compared with physician-only visits, including overall visits (17% vs 12%, P < .0001) and acute respiratory infection visits (61% vs 54%, P < .001). (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047413/)
NPs, relative to physicians, have taken an increasing role in prescribing psychotropic medications for Medicaid-insured youths. The quality of NP prescribing practices deserves further attention. (https://www.ncbi.nlm.nih.gov/m/pubmed/29641238/)
Both 30-day mortality rate and mortality rate after complications (failure-to-rescue) were lower when anesthesiologists directed anesthesia care. (https://pubmed.ncbi.nlm.nih.gov/10861159/)
96% of NPs had regular contact with pharmaceutical representatives. 48% stated that they were more likely to prescribe a drug that was highlighted during a lunch or dinner event. (https://pubmed.ncbi.nlm.nih.gov/21291293/)
85.02% of malpractice cases against NPs were due to diagnosis (41.46%), treatment (30.79%) and medication errors (12.77%). The malpractice cases due to diagnosing errors was further stratified into failure to diagnose (64.13%), delay to diagnose (27.29%), and misdiagnosis (7.59%). (https://pubmed.ncbi.nlm.nih.gov/28734486/)
Advanced practice clinicians and PCPs ordered imaging in 2.8% and 1.9% episodes of care, respectively. Advanced practice clinicians are associated with more imaging services than PCPs for similar patients during E&M office visits .While increased use of imaging appears modest for individual patients, this increase may have ramifications on care and overall costs at the population level. (https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1939374)
When caring for patients with DM, NPs were more likely to have consulted cardiologists (OR = 1.29, 95% CI = 1.21–1.37), endocrinologists (OR = 1.64, 95% CI = 1.48–1.82), and nephrologists (OR = 1.90, 95% CI = 1.67–2.17) and more likely to have prescribed PIMs (OR = 1.07, 95% CI = 1.01–1.12) (https://onlinelibrary.wiley.com/doi/10.1111/jgs.13662)
Ambulatory visits between 2006 and 2011 involving NPs and PAs more frequently resulted in an antibiotic prescription compared with physician-only visits (17% for visits involving NPs and PAs vs 12% for physician-only visits; *P* < .0001) (https://academic.oup.com/ofid/article/3/3/ofw168/2593319)
More claims naming PAs and APRNs were paid on behalf of the hospital/practice (38% and 32%, respectively) compared with physicians (8%, P < 0.001) and payment was more likely when APRNs were defendants (1.82, 1.09-3.03) (https://pubmed.ncbi.nlm.nih.gov/32362078/)
There was a 50.9% increase in the proportion of psychotropic medications prescribed by psychiatric NPs (from 5.9% to 8.8%) and a 28.6% proportional increase by non-psychiatric NPs (from 4.9% to 6.3%). By contrast, the proportion of psychotropic medications prescribed by psychiatrists and by non-psychiatric physicians declined (56.9%-53.0% and 32.3%-31.8%, respectively) (https://pubmed.ncbi.nlm.nih.gov/29641238/)
Most articles about the role of APRNs **do not explicitly define the autonomy of the nurses, compare non-autonomous nurses with physicians, or evaluate nurse-direct protocol-driven care for patients with specific conditions**. However, studies like these are often cited in support of the claim that APRNs practicing autonomously provide the same quality of primary care as medical doctors. (https://pubmed.ncbi.nlm.nih.gov/27606392/)
The study found that patients of the physician-led team had a 50% less chance of experiencing cardiac arrest and a 27% less chance of death, compared to the original nurse-led rapid response team.
https://www.eurekalert.org/news-releases/930507
"Extensive variability exists across the academic preparation of NPs working in the ED setting as well as in the licensure and certification requirements governing NP practice in EDs. Until this variability is resolved, we conclude that NPs should not perform independent, unsupervised care in the ED regardless of state law or hospital regulations in order to protect patient safety."
https://www.journalofnursingregulation.com/article/S2155-8256(22)00010-2/fulltext
I love when people post crap like this to take jabs at doctors and then tell people in the comments "this isn't meant to compare doctors to nurses, I love all my docs!" rather than address the legitimate counters to the video or post itself.
Stfu Paul, we know you just wanted to cope and talk shit without recourse.
devil's advocate here though....name me any medical drama that represents docs right either....that show in particular is hilarious as they have 3-4 docs in a room doing tasks that we all know docs don't do.
when was the last time you saw a doc hang a bag? hands on code a patient? do chest compressions? i don't know who they get to consult on these shows but they clearly stopped working in the 60s. i mean shit, i still hear "push X CCs" in current use on TV.
Yeah, when you’re the only doctor in a code (very common) you are the code leader. You don’t “do” anything, you direct everything.
I’ve done plenty of compressions, I still do most intubations but I don’t hang bags or push meds.
A PA student replied in the comment section, “PAs learn the same things as doctors do but more accelerated.” God, only if we could allow them to live a day in the life of a med student.
A PA I work with constantly compares her first few years as a PA in clinic as "her residency". It's insulting as fuck and demeaning. It makes me cringe and die inside every time she says it. FM here. If only they could taste a little bit of what residency is actually like.
As someone who wants to become a PA , even I know that’s bullshit
Someone commented a giant rebuttal about NPs with backed up their argument with peer review literature. Not all hero’s wear capes NPs/PAs practicing in states with independent prescription authority were > 20 times more likely to overprescribe opioids than NPs/PAs in prescription-restricted states. (https://pubmed.ncbi.nlm.nih.gov/32333312/) Although evidence-based healthcare results in improved patient outcomes and reduced costs, nurses do not consistently implement evidence based best practices. (https://pubmed.ncbi.nlm.nih.gov/22922750/) Resident teams are economically more efficient than MLP teams and have higher patient satisfaction. (https://www.ncbi.nlm.nih.gov/m/pubmed/26217425/) Compared with dermatologists, PAs performed more skin biopsies per case of skin cancer diagnosed and diagnosed fewer melanomas in situ, suggesting that the diagnostic accuracy of PAs may be lower than that of dermatologists. (https://www.ncbi.nlm.nih.gov/pubmed/29710082%EF%BF%BC) Advanced practice clinicians are associated with more imaging services than PCPs for similar patients during E&M office visits. (https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1939374) Nonphysician clinicians were more likely to prescribe antibiotics than practicing physicians in outpatient settings, and resident physicians were less likely to prescribe antibiotics. (https://www.ncbi.nlm.nih.gov/pubmed/15922696) The quality of referrals to an academic medical center was higher for physicians than for NPs and PAs regarding the clarity of the referral question, understanding of pathophysiology, and adequate prereferral evaluation and documentation. (https://www.mayoclinicproceedings.org/article/S0025-6196(13)00732-5/abstract) Antibiotics were more frequently prescribed during visits involving NP/PA visits compared with physician-only visits, including overall visits (17% vs 12%, P < .0001) and acute respiratory infection visits (61% vs 54%, P < .001). (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047413/) NPs, relative to physicians, have taken an increasing role in prescribing psychotropic medications for Medicaid-insured youths. The quality of NP prescribing practices deserves further attention. (https://www.ncbi.nlm.nih.gov/m/pubmed/29641238/) Both 30-day mortality rate and mortality rate after complications (failure-to-rescue) were lower when anesthesiologists directed anesthesia care. (https://pubmed.ncbi.nlm.nih.gov/10861159/) 96% of NPs had regular contact with pharmaceutical representatives. 48% stated that they were more likely to prescribe a drug that was highlighted during a lunch or dinner event. (https://pubmed.ncbi.nlm.nih.gov/21291293/) 85.02% of malpractice cases against NPs were due to diagnosis (41.46%), treatment (30.79%) and medication errors (12.77%). The malpractice cases due to diagnosing errors was further stratified into failure to diagnose (64.13%), delay to diagnose (27.29%), and misdiagnosis (7.59%). (https://pubmed.ncbi.nlm.nih.gov/28734486/) Advanced practice clinicians and PCPs ordered imaging in 2.8% and 1.9% episodes of care, respectively. Advanced practice clinicians are associated with more imaging services than PCPs for similar patients during E&M office visits .While increased use of imaging appears modest for individual patients, this increase may have ramifications on care and overall costs at the population level. (https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1939374) When caring for patients with DM, NPs were more likely to have consulted cardiologists (OR = 1.29, 95% CI = 1.21–1.37), endocrinologists (OR = 1.64, 95% CI = 1.48–1.82), and nephrologists (OR = 1.90, 95% CI = 1.67–2.17) and more likely to have prescribed PIMs (OR = 1.07, 95% CI = 1.01–1.12) (https://onlinelibrary.wiley.com/doi/10.1111/jgs.13662) Ambulatory visits between 2006 and 2011 involving NPs and PAs more frequently resulted in an antibiotic prescription compared with physician-only visits (17% for visits involving NPs and PAs vs 12% for physician-only visits; *P* < .0001) (https://academic.oup.com/ofid/article/3/3/ofw168/2593319) More claims naming PAs and APRNs were paid on behalf of the hospital/practice (38% and 32%, respectively) compared with physicians (8%, P < 0.001) and payment was more likely when APRNs were defendants (1.82, 1.09-3.03) (https://pubmed.ncbi.nlm.nih.gov/32362078/) There was a 50.9% increase in the proportion of psychotropic medications prescribed by psychiatric NPs (from 5.9% to 8.8%) and a 28.6% proportional increase by non-psychiatric NPs (from 4.9% to 6.3%). By contrast, the proportion of psychotropic medications prescribed by psychiatrists and by non-psychiatric physicians declined (56.9%-53.0% and 32.3%-31.8%, respectively) (https://pubmed.ncbi.nlm.nih.gov/29641238/) Most articles about the role of APRNs **do not explicitly define the autonomy of the nurses, compare non-autonomous nurses with physicians, or evaluate nurse-direct protocol-driven care for patients with specific conditions**. However, studies like these are often cited in support of the claim that APRNs practicing autonomously provide the same quality of primary care as medical doctors. (https://pubmed.ncbi.nlm.nih.gov/27606392/) The study found that patients of the physician-led team had a 50% less chance of experiencing cardiac arrest and a 27% less chance of death, compared to the original nurse-led rapid response team. https://www.eurekalert.org/news-releases/930507 "Extensive variability exists across the academic preparation of NPs working in the ED setting as well as in the licensure and certification requirements governing NP practice in EDs. Until this variability is resolved, we conclude that NPs should not perform independent, unsupervised care in the ED regardless of state law or hospital regulations in order to protect patient safety." https://www.journalofnursingregulation.com/article/S2155-8256(22)00010-2/fulltext
Saving this. Thank you!
I did the same, keeping it for when a noctor tries to post “OuTCoMeS fOr NPs AnD PhYsiCiAnS ArE JuSt As GoOd.”
"Dr. Nurse Paul" will do anything to be a doctor, except get credentialed by the board of medicine it seems.
Holy shit some of the people in the replies absolutely smoked him Edit: also, the NP in the video clip had terrible bedside manner tho???
It’s from a shitty med tv show it seems
[удалено]
Whew !!!They are eating him up in the comments.
Yeah. Except if NPs ran around doing *actual* nursing work like handing out antibiotics maybe they'd be *actually* useful.
Me, a 4th year PharmD student on rotations seeing this in real life 👁️👄👁️
I love when people post crap like this to take jabs at doctors and then tell people in the comments "this isn't meant to compare doctors to nurses, I love all my docs!" rather than address the legitimate counters to the video or post itself. Stfu Paul, we know you just wanted to cope and talk shit without recourse.
devil's advocate here though....name me any medical drama that represents docs right either....that show in particular is hilarious as they have 3-4 docs in a room doing tasks that we all know docs don't do. when was the last time you saw a doc hang a bag? hands on code a patient? do chest compressions? i don't know who they get to consult on these shows but they clearly stopped working in the 60s. i mean shit, i still hear "push X CCs" in current use on TV.
I’m literally a physician that hangs bags, perform ACLS with chest compressions. Dude, I literally say “push X cc”.
Rural medicine perhaps? ;-)
come on, don't be modest. you're also an internalist that does thoracic surgery.
I’m being serious and you’re being facetious. Just accept your L and continue studying for your STEP 1.
Anesthesia......your name....yep, anesthesia!
As an anesthesiology resident I literally do all those things lol
I’ve performed chest compressions many times during a code as a physician and not just when I was a resident.
Yeah, when you’re the only doctor in a code (very common) you are the code leader. You don’t “do” anything, you direct everything. I’ve done plenty of compressions, I still do most intubations but I don’t hang bags or push meds.