Nurses for Doctors

[garret9]

http://www.msnbc.msn.com/id/44748258/ns/health-health_care/t/when-nurse-wants-be-called-doctor/#.To5khXOXNAE

 

I'm sure this link or similar one has been discussed at some point but it's quite interesting. Specially when they say:

Studies have shown that nurses with master’s level training offer care in many primary care settings that is as good as and sometimes better than care given by physicians, who generally have far more extensive training. And patients often express higher satisfaction with care delivered by nurses, studies show. Physicians say they are better at recognizing rare problems, something studies have trouble measuring.

 

Ooohhh msnbc....

[aaronjw]

Uhhhh Nurses have more extensive training?

[Ekylo]

Interesting. I wouldn't be against of nurses assuming some of the roles doctors have in primary care ... not sure about them having the doctor's role in it's entirety. Although there are lots of simularities, doctors and nurses have very different training. I'm not expert with curriculums but I would guess that doctors would have more training with diagnosis, which is a huge role in primary care. They're the first gate-way in directing patients to specialists, etc.

 

There is also the issue of territory battles amongst health professions. Pharmacists are beginning to have larger roles in this sort of thing as well ..

 

And, rules and regulations of the exact role nurses will have and when they have to hand cases over to doctors would have to be made.

[Jochi1543]

Uhhhh Nurses have more extensive training?

 

Reading comprehesion. It says docs have more extensive training, but nurses with master's degrees (I guess they mean NPs?) are just as competent.

[Jochi1543]

 

And, rules and regulations of the exact role nurses will have and when they have to hand cases over to doctors would have to be made.

There's SO much variation in terms of how much different kinds of nurses are allowed to do. On my current rotation, NAs are doing MORE than many of the RNs are allowed to do at other facilities. Other places, NAs are just changing and bathing people.

[seeking1]

http://www.msnbc.msn.com/id/44748258/ns/health-health_care/t/when-nurse-wants-be-called-doctor/#.To5khXOXNAE

 

I'm sure this link or similar one has been discussed at some point but it's quite interesting. Specially when they say:

Studies have shown that nurses with master’s level training offer care in many primary care settings that is as good as and sometimes better than care given by physicians, who generally have far more extensive training. And patients often express higher satisfaction with care delivered by nurses, studies show. Physicians say they are better at recognizing rare problems, something studies have trouble measuring.

 

Ooohhh msnbc....

 

Regarding that fact about equivalent care that MSNBC is quoting, they are being misleading.

 

That fact has been extracted from a Cochrane Review, which can be found here: http://www2.cochrane.org/reviews/en/ab001271.html

 

If you read into it, you begin to see that the evidence for the conclusion is substantially limited. The main thrust for employing more nurses over doctors in primary care is to reduce the cost of health care. However, the last paragraph of this Review actually directly contests that idea:

 

"While doctor-nurse substitution has the potential to reduce doctors' workload and direct healthcare costs, achieving such reductions depends on the particular context of care. Doctors' workload may remain unchanged either because nurses are deployed to meet previously unmet patient need or because nurses generate demand for care where previously there was none. Savings in cost depend on the magnitude of the salary differential between doctors and nurses, and may be offset by the lower productivity of nurses compared to doctors."

[A-Stark]

Regarding that fact about equivalent care that MSNBC is quoting, they are being misleading.

 

That fact has been extracted from a Cochrane Review, which can be found here: http://www2.cochrane.org/reviews/en/ab001271.html

 

If you read into it, you begin to see that the evidence for the conclusion is substantially limited. The main thrust for employing more nurses over doctors in primary care is to reduce the cost of health care. However, the last paragraph of this Review actually directly contests that idea:

 

"While doctor-nurse substitution has the potential to reduce doctors' workload and direct healthcare costs, achieving such reductions depends on the particular context of care. Doctors' workload may remain unchanged either because nurses are deployed to meet previously unmet patient need or because nurses generate demand for care where previously there was none. Savings in cost depend on the magnitude of the salary differential between doctors and nurses, and may be offset by the lower productivity of nurses compared to doctors."

 

Hah. If there is one thing many nurses are exceptionally capable of, it's generating demand for care where previously there was none. In fact, that's almost the definition of medicine floor call.

[Renin]

Hah. If there is one thing many nurses are exceptionally capable of, it's generating demand for care where previously there was none. In fact, that's almost the definition of medicine floor call.

 

+1 HAHA.

 

While not entirely true, certainly amusing.

[Guest copacetic]

nurse practitioners typically spend more time with patients than physicians. They typically manage less complex cases (which in any practice family, or specialist) will make up 70% of what you do. what ends up happening is that patients walk away from the experience feeling that they were well taken care of because of the extra time and attention, so their satisfaction increases. The main gripe that most patients will have with a doctor is a sense that their doctor doesnt care, or didnt spend time with them, or wanted to rush them out. while physicians will typically be billing per patient, nurses will normally have a fixed salary so really there is no incentive to be rushing anybody anywhere. Their not paying the overhead so they dont have to worry about that.

[seeking1]

+1 HAHA.

 

While not entirely true, certainly amusing.

 

 

Please explain the joke to me, either in this thread or by pm. I don't get it, but I want to.

[seeking1]

nurse practitioners typically spend more time with patients than physicians. They typically manage less complex cases (which in any practice family, or specialist) will make up 70% of what you do. what ends up happening is that patients walk away from the experience feeling that they were well taken care of because of the extra time and attention, so their satisfaction increases. The main gripe that most patients will have with a doctor is a sense that their doctor doesnt care, or didnt spend time with them, or wanted to rush them out. while physicians will typically be billing per patient, nurses will normally have a fixed salary so really there is no incentive to be rushing anybody anywhere. Their not paying the overhead so they dont have to worry about that.

 

I don't get where you are going with this....

[Guest copacetic]

im simply explaining why patients walk away from the nursing experience feeling that they have had better care. Its a time issue. yes nurses and doctors are fully capable each of handling the less complex cases, but the doctors typically spend less time with each patient. its backed up by studies, and also my own personal experience working with nurse practitioners.

[medigeek]

Twice on telehealth theyve told me a physician is required for more info and all they did was "go to the ER." And I wasnt even asking anything specific or anything involving liability.

 

I dont know where these "doctor nurses" are hiding cause it must be pretty rare...

[Jochi1543]

Twice on telehealth theyve told me a physician is required for more info and all they did was "go to the ER." And I wasnt even asking anything specific or anything involving liability.

 

I dont know where these "doctor nurses" are hiding cause it must be pretty rare...

 

Well, to be fair, you'd probably be getting the same advice from a doctor on the phone. You can't do much without seeing someone face-to-face, taking their vitals, and running a couple of tests.

[medigeek]

Well, to be fair, you'd probably be getting the same advice from a doctor on the phone. You can't do much without seeing someone face-to-face, taking their vitals, and running a couple of tests.

 

No I was asking for a general likelihood percentage, to get an idea. And she had no clue.