Nurse practitioner delusion / "Noctors" / "Midlevel staff" - Nurses get a 1 year degree and start thinking they are better than doctors

[John Andrews Stan]

Recently made an appointment with a new doc and instead his PA was the one who saw me. I actually really liked her but it did make me think that there’s a bit of bait and switch going on here. What if I’d have demanded to see the doctor? I have a feeling they’d have shut me down and sent me a bill anyway.

 

[Aunt Carol]

Recently made an appointment with a new doc and instead his PA was the one who saw me. I actually really liked her but it did make me think that there’s a bit of bait and switch going on here.

The office should have let you know that's who you'd be seeing. Around here, they even ask if that's OK for now.

 

[Big Bang]

Recently made an appointment with a new doc and instead his PA was the one who saw me. I actually really liked her but it did make me think that there’s a bit of bait and switch going on here. What if I’d have demanded to see the doctor? I have a feeling they’d have shut me down and sent me a bill anyway.

If they do that without letting you know beforehand (it's happened to me), you're not required to pay if you refuse to be seen by them (even if they're in the same room as you).

 

[SpergioLeonne]

Recently made an appointment with a new doc and instead his PA was the one who saw me. I actually really liked her but it did make me think that there’s a bit of bait and switch going on here. What if I’d have demanded to see the doctor? I have a feeling they’d have shut me down and sent me a bill anyway.

Well, sometimes you’ll have a couple of “screening” visits.

During covid, I’ve had a toddler in daycare. For about a year, I was constantly sick with different shit at the same time and my immune system got exhausted. Some asshat at an urgent care clinic (I needed a note for missing work) decided to draw blood and noticed I had high levels of lymphocytes, so they pretty much told me I had leukemia and made a referral for oncology at the local hospital.

It took like three different visits and six months before I met my actual oncologist, just for her to tell me ten minutes into the appointment that I don’t have cancer.

 

[Woe-B-Gon (TM)]

I had high levels of lymphocytes, so they pretty much told me I had leukemia and made a referral for oncology at the local hospital.

Good heavens, when I actually HAD cancer my doctor AND my surgeon wouldn't even use the word until after the biopsy was back. Like I was being prepped for surgery and the surgeon was still talking about the hypothetical that he might open me up and find everything was peachy, despite having an array of bloodwork and scans convincing enough to perform surgery in the first place. They hate committing to that word.

 

[SpergioLeonne]

Good heavens, when I actually HAD cancer my doctor AND my surgeon wouldn't even use the word until after the biopsy was back. Like I was being prepped for surgery and the surgeon was still talking about the hypothetical that he might open me up and find everything was peachy, despite having an array of bloodwork and scans convincing enough to perform surgery in the first place. They hate committing to that word.

Idk if the whole Covid thing got them to the point of too exhausted to care, or if the first Doctor Redditor guy was just an autist who let the cat out of the bag, but yeah. I had a good six months of wondering if I’d live long enough for my daughter to remember me

 

[John Andrews Stan]

I mean is it me or is the healthcare industry using COVID as an excuse to fob people off with cheaper medical labor while still charging doctor rates?

 

[Aunt Carol]

I mean is it me or is the healthcare industry using COVID as an excuse to fob people off with cheaper medical labor while still charging doctor rates?

It might have been COVID, but now it's collapse. Staff at all levels are quitting if they can, remaining staff are given more work until they quit too. Outpatient, inpatient, SNF, LTC, private pharmacies. It is a wild time to need health care and/or work in health care.

If people try to warn the public about this, they get a kneejerk "well they all quit because of vaccine mandates," almost as though it was a programmed response, ready for this crisis. Fear of HIPAA and employer reprisal are keeping people from speaking out; it's an inchoate murmur through the professions.

This writer would start a thread about it, but this writer is kind of a dumbass who is already panicking enough due to anecdotal experiences.

 

[Jet Fuel Johnny]

I mean is it me or is the healthcare industry using COVID as an excuse to fob people off with cheaper medical labor while still charging doctor rates?

According to someone I know, it's that the ones who actually worked all through The 'Vid expected some time off or something, maybe vacation days or a raise or something, since they were working long shifts almost every day while a ton of people hid in their houses.

Then The 'Vid ended and all the management came back and thought that since they were willing to work those hours for that pay before, they should be willing to now, because it would let them downsize the people who actually work to increase the pay and benefits of the people in upper management who are so far removed from doctors and nurses they probably don't know what a Band-Aid is.

So a lot of people, wrung out and burnt out from The 'Vid, were told that their new schedule was the one during the Pandemic, for the same pay, and oh, you obviously don't need those benefits so we're slashing them. YAY! It's a record profit! All Upper Management get six figure bonuses!

They just quit. It wasn't worth it.

 

[std::string]

Then The 'Vid ended and all the management came back and thought that since they were willing to work those hours for that pay before, they should be willing to now, because it would let them downsize the people who actually work to increase the pay and benefits of the people in upper management who are so far removed from doctors and nurses they probably don't know what a Band-Aid is.

This is pretty much it.

Admin realized that no patient sued them making new grads staff med/surg at 1:8 while titrating drips and so that's the new normal now. Patient care takes an absolute nosedive and you'll never retain nurses this way, but hey, you might get a pat on the back from the higher ups by burning out every single nurse that makes the mistake of working for your hospital because you cut staffing expenditures by 11%.

 

[John Andrews Stan]

A friend’s adult child is getting her PA license and she said to me, “Of course I’m nothing but supportive, but how can she learn enough in 18 months to make her a stand-in for a physician who’s had 12+ years of training and schooling?” It just doesn’t make sense.

 

[Dan Abrams]

A friend’s adult child is getting her PA license and she said to me, “Of course I’m nothing but supportive, but how can she learn enough in 18 months to make her a stand-in for a physician who’s had 12+ years of training and schooling?” It just doesn’t make sense.

Although this is n=1 I am happy to hear a report of normal people wondering why we're making not doctors work as doctors.

 

[Crunchy Leaf]

I live in a mid-sized American city and our light rail has been covered in ads from the American Association of Physician Assistants saying 'we don't see patients, we see Sophie" and I can't stand it.

I was also *on the r/Noctor sub* on a post about a DNP getting in trouble for calling herself 'Dr Sarah' and running a clinic and someone had the nerve to say in the replies that 'well, she's technically a doctor...' I wish English had a distinction between what we called people with an academic doctorate and what we called physicians.

 

[folly magnet]

A friend’s adult child is getting her PA license and she said to me, “Of course I’m nothing but supportive, but how can she learn enough in 18 months to make her a stand-in for a physician who’s had 12+ years of training and schooling?” It just doesn’t make sense.

To be honest, given what the primary care doctors around me are like, the patients might as well see a PA or NP. They're all very high volume outfits, mainly do some basic screening, order lab tests and the like, if there's anything remotely concerning, refer to a specialist. At this point, people here mainly have PCPs so they can get specialist referrals.

 

[msd]

You know when I was smaller I wanted to get into medical

Glad I jumped ship and just work manual shit now

 

[$80 Nude Haircut]

You know when I was smaller I wanted to get into medical

Glad I jumped ship and just work manual shit now

Work in biological weaponry, it's a gas.

 

[The Sea Witch]

I've only had one place here try to farm me out to a PA when I wanted to see an MD, initially when I setup the visit I was told it couldn't be scheduled with a real doctor until I saw a PA first. I scheduled it figuring I could change it later...and luckily when I did call to reschedule it a super-nice operator helped me out and scored me a telemed visit within the hour - that was with an actual MD. Thank fucking god.

Be nice to your operators, folks. They're the ones with the real power.

Anyway, a lot of the bullshit being told to patients about needing to see PA's "first" is because docs and nurses are mass quitting and the little space is even more limited. It's why I need a new GI.

Are we winning again yet?

edit...clarity. I get rambly sometimes, so editing is my friend.

 

[std::string]

To be honest, given what the primary care doctors around me are like, the patients might as well see a PA or NP. They're all very high volume outfits, mainly do some basic screening, order lab tests and the like, if there's anything remotely concerning, refer to a specialist. At this point, people here mainly have PCPs so they can get specialist referrals.

In the US a lot of this has to do with how outpatient reimbursement is structured.

Spending an hour and a half with one patient would net you about $220 from Medicare. You could knock out 6 level 4 visits in that period of time for around $800. Private insurance reimbursement tends to hover around Medicare rates, so it's broadly similar.

Medicare reimbursement honestly has barely changed since the 90s but operating costs are obviously much higher now. You literally can't even keep the lights on if you're not seeing at least three patients an hour. That's like the bare minimum. Nobody would mind doing long patient visits if it actually brought in the revenue needed to keep things running.

 

[msd]

Work in biological weaponry, it's a gas.

You really just hit me with a pun?

 

[Tom Myers]

I fucking hate NPs. I pay the EXACT SAME RATE for SUBPAR TREATMENT! This one bitch put me on anti-psychotics and quoted Semi-charmed life. Bitch, I have regular depression.