Doctors vs Nurse Practioners. You Decide.

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The Affordable Care Act is starting at a time where there are now fewer primary-care physicians than ever before when there needs to be more. What is being done is that nurse practitioners are being the ones to take up this slack. I'm doing a paper on doctors vs nurse practitioners and found this article from a doctor who is NOT in favor of having nurse practitioners taking over primary-care doctor's positions. Starting in 2015, nurse practitioners are going to now be able to work on their own where before they had to work under a physician.

My question is - 1) Are you in favor of the Affordable Care Act? AND
** 2) Would you be ok with having a nurse practitioner fulfill your healthcare needs instead of a doctor?


Here is the article: http://www.nytimes.com/2014/04/30/opini ... .html?_r=0

The last NP that I talked to ignored my complaint of a sore throat, and spent 20 minutes trying to convert me to Veganism. I was sick with pneumonia or the flu for the next two weeks, complete with gurgling lungs, blurred vision, and a fever that spiked at 103 degrees (F) - I never did get a professional diagnosis.

The one before that would only speak to my wife, as if I was too stupid to speak for myself. When she wasn't asking my wife to describe my symptoms, she was pressing my wife for any indication that I was abusing her.

The one before that only verified my identity before calling in an LVN to take my vitals. The LVN then left me alone for 15 minutes before coming back with the NP's diagnosis and a scrip for a mild opiate when it explicitly states in my record that I am allergic to certain opioids!

This was under Kaiser-Permanente, by the way - not Obamacare.

No more wannabe doctors for me. Gimme the real doctors every time!

Why aren't PAs (Physician Assistants) being considered ?

Bad experience with nurse-practitioners. They aren't necessarily that smart or knowledgeable. Not a fan of physician assistants either.

I see a lot of doctors, nurse practitioners, and physician's assistants. I'm usually smarter and more knowledgeable about my condition than the nurse practitioners and physician's assistants. That's bad. Very, very bad. These are people who are supposed to know a lot about their specialty. They don't.

I don't have a problem with NPs and PAs. In fact, whenever I take Mom to the clinic, she rarely gets to see her doctor. That's fine with me because I've never liked his bedside manner -- very detached and somewhat arrogant. He is a good doctor, though, but I would rather deal with his assistants.

The real question should be--how to we get more really good Primary Care Physicians? Doctors who know as much as a genius Aspie but with the bedside manner of a normal person. This Obamacare stuff is just a smokescreen. The author of the NYT articles says to pay them more--is that really going to help the bedside manner of doctors?

In my state (Utah), at least, nurse practitioners are required to complete the same eight years of college, the same tests and the same licensing. As such, they are legally able to perform every function which a medical doctor may perform except invasive surgery. My nurse practitioner of 16 years has believed and cared for me when most of my medical doctors didn't. YMMV, of course.

Only similar equivalent is specialist nursing, where they do certain tasks or are trained to consult on a particular conditions. Diabetic nurse, mental health nurse for example. They aren't really a substitute for doctors, since the people already have a diagnosis, or they have been told to go there.

However this is different from doing the full diagnosis. They give advice, etc.

If specialists make 3 times as much money--doesn't that mean we need them as well?
Or, according to basic economics, we need specialists much more that Primary Care Physicians, or the market wouldn't value them so much. Getting potential specialists to be PCPs doesn't sound like sensible solution.

How about this theory? There is a shortage of PCPs because our current method of training doctors results in a significant percentage of subclinical Aspies--folks who are really smart, but lack the social skills to be true PCPs. If this is the case, more pay won't help--they just don't have the aptitude to be PCPs and enticing them with money won't fix their lack of social skills. Instead they become Specialists who don't have to form lifelong bonds with their patients.

There are tons of Aspie experts here who know all about the ability to miraculously learn social skills given the opportunity for more pay.