Since the organization has completely lost the trust of frontline working physicians, they are now now turning to nurse practitioners to promote their certification products - all at real working physician expense!
Spend a moment and watch the good "doctor and nurse practitioner" Susan Apold, PhD, ANP promote nurse practitioners as equals to physicians on national TV:
Caveat emptor.
-Wes
Anyone with even the tiniest shred of ethics would be extremely careful of intermingling the title "Dr." with their NP credentials. Wow ABIM - once again you show your level of ethical behaviour!
ReplyDeleteIt took me a while, but I think I finally have it. First you beat up on doctors through the news circuit making the case NPs have learned in a few hundred hours to do what it took physicians 12,000 hours to learn. Wow, those NPs are quick learners. Then you join the ABIM Board and beat up on physicians by taking away their credential when the docs won’t ante up the money or be finger printed at a testing center. The ABIM really does know something about “choosing wisely.”
ReplyDeleteTry as you might NP or PA, you'll never be an MD; must be agonizing. Why don't you try nursing for a change? Goodness knows real nurses are needed.
ReplyDeleteSince you NPs are in such an expansive frame of mind re defining the limits of your license, why stop at mere MD? Why not add aeronautical engineering, Doctor of Divinity and sous chef? Come now, you're limiting yourselves. A true renaisance profession, bravo!
ReplyDeleteIt seems that the strategy of the ABIM is to develop a new revenue stream by trying to pass NP's off as autonomous providers providing that they sign up to take their version of MOC. As there will be a physician shortage, it would seem logical as a business model by the ABIM that the ABIM would throw their weight behind autonomous NP practitioners as long as they sign up for NP-MOC. I would not be surprised if lobbying groups for the ABIM are pushing legislation for this to happen as long as the NP's submit to the ABIM.
ReplyDeleteThe corporate financial push to find the lowest common denominator to fulfill the roll of healthcare provider (I’ve given up having any administrator acknowledge me as a doctor) does not stop at Nurse Practitioners. MAs (high school graduates trained to have an automated device measure vital signs), “Certified” MAs (Medical Assistnants having passed a 6 week course in administering immunizations), or iPADs that take a medical history and render a differential diagnosis are already in place. I certainly hope NPs enjoy paying their expanding malpractice insurance premiums that will certainly follow their enhanced set of responsibilities.
ReplyDeleteSilly, me, they work in conjunction with a physician so the physician will absorb this responsibility.
Get over yourselves. There are already physicians who have seriously at least looked into becoming nurse practitioners just to circumvent MOC bullshit and continue caring for patients. Depending on specialty, IDGAF what job title someone has. It would concern me if surgeons were becoming NP's and still doing surgery because it becomes harder to verify if there is the correct skillset to do that.
ReplyDeleteWe all know the doctor shortage is intentionally created, and this is something that needs to be more seriously addressed as a nation in ways other than: OMG we simply HAVE TO import savior doctors from other countries because only immigration can save us. If you're a white American then you are most likely NOT going to medical school, and if you do then you pay full retail pricing. Policy that demands full replacement of the host nation is problematic. At some point this trajectory makes USA a third world country populated by only third world people. It's not magic soil; it would just be another third world cesspool.
If I had a good NP to go to, I would not hesitate. Medicine has become some freakish priesthood of the "good people" who are superior in all ways human and divine because of Elite BMI. "I am the great one; I have a twelve inch waist; I am a good example who provides leadership to the little people who have immoral fat lifestyles" and then the dipshit writes a prescription for a problem the patient doesn't have AND says so; or it's the "90% of patients who are just coming to see a physician because of anxiety or need for reassurance". When doctors poll at claiming 90% of their patients are not visiting a doctor for a medical reason, there is such a serious disconnect with vocation. People do not waste time and money to sit and wait for the doctor and just be told it's nothing dear.
I think it was Medscape who ran an article on that stat. If you're "batting 100" then you are not a medical professional and you need to do something else besides disgrace some of the most highly trained resources in this country. Literally, I have lost track of how many times I have had to PAY for a consult and then I have to explain basic medicine to the white coat. The white coat does not bestow superpowers. If you do not know something then don't bullshit. You can say "let me check into that for you". When patients can google something and get a better medical consult then you need to just do something else. I'm against most physician suicide, but if you're incompetent then please just do something else.
Go ahead: #ConfrontWhiteWomanhood I still stand behind every word I said. If you're reading Wes' blog though, the chances are extremely slim that you are one of the grossly incompetent physicians degrading the profession. Those people probably don't read anything medical. Don't cover up: if I could get in touch with my inner bitch, then I know you all have it within you as well. If you live in a state where NP's have autonomy and got credentialed as that instead of being beaten down re-certifying with ABIM then I respect your pragmatic ways and dedication to patient care.
Lisa, your rant is divisive, racist and lacking facts. It's clear that you have an extreme personal bias, get help.
DeleteLisa, you're a special kind of stupid. Medicine is harder than surgery. It's not about job titles, it's about having enough education and training. True, we should be training more American doctors rather than importing undertrained foreign doctors, but the answer isn't to dumb down medical training to far less than even what a foreign doctor has.
DeleteThe move to use midlevels to replace MDs and also DOs is simply outsourcing. We have seen this in manufacturing as jobs moved to Asia since the 1980s. Now we see high tech computer jobs go to India in the last 10 years. Now that many states allow barely trained NPs to practice independently as in my state of WA, the PAs are also clamoring to seek legal independence . This helps the payors ( Govt/ insurance) so they can dilute the provider workforce. What will be interesting is when these little league practitioners make a big mistake and end up killing or maiming a patient. The courts will judge their practice against the local physician standard ; this will be a boon for trial lawyers as they put a NP/PA up against expert MD witnesses and are found to be substandard in care.......The tort laws have not been changed to make NPs immune to medical malpractice and they may face very high malpractice fees in the future , like a bad driver trying to get care insurance.
ReplyDeleteKen Lee is right: many of us have noticed we are being replaced. The United Nations insists upon it. South Asia is not turning out superstar physicians anymore than they are turning out superstar IT workers. But they endorse each other and share exam scores so on paper they can look pretty good as though the employer is getting something superior at a bargain price. We're also being bombarded with propaganda that would lead the naive to believe that Asians of any sort are of far superior intelligence. USA brain-drained certain countries during the time of meritocracy so those people we had experience with were the top 1% of their group.
ReplyDeleteNow there is even a commercial showing mostly Asians complaining they are not all the same, not all good at math. They are people. This cracked me up:
https://twitter.com/chelmex/status/942994698121240576
Patients are already being killed and maimed, usually killed. If someone maims the rest of the healthcare providers try to jump in and get a kill so no one can sue, make it look like natural causes, cover up, re-write patient history to discredit the victim. When I was a kid there was such a fuss about physicians running advertisements and this seems unprofessional and could degrade the medical profession. I seriously grew up hearing that complaint constantly. Now it's barely a profession in some regions, or maybe that is national, I do not know. I like to think I am just living in a complete hellhole and this is not how the rest of America is living, that there is somewhere to escape to. Amazing how fast we went from is it proper for a physician to take out ad space to how much longer must we wait for DOJ to bring down this criminal cartel? Just a few decades and look where we are. The immigration reform we need is STOP immigration unless we're really brain-draining as asset that's good for America.
Ok, so if you go to medical school, just choose any speciality but no IM and FP. No one wants to work as pcp any more. PA and NP will see patients and refer everyone. Thanks to ABIM,
ReplyDeleteDisappointing and, frankly, inappropriate. SHE doesn’t take INTERNAL MEDICINE BOARDS, like PHYSICIANS do. Ridiculous and first chance I get to become a nonmember I will.
ReplyDeleteI’m sorry but SHE doesn’t even take the IM BOARD EXAMS or participate in MOC. This is simply ridiculous and the minute I’m able to be a nonmember consider it done.
ReplyDeleteWhether in private or hospital based, solo or group practice, the delivery of medical care requires a team, as does flying a passenger jet, manipulating a submarine, or playing football, baseball, basketball, etc. NPs play a growing and critical role in this team project but the navigator doesn't fly the jet, the ensign doesn't manage the submarine, and the equipment manager doesn't shoot three pointers or make a hat trick. What a silly and divisive argument. When there is a shortage of pilots the response is not to embolden the flight attendants but to train and incentivize more students to become pilots. Should medicine be any different?
ReplyDeleteGood luck to patient's presenting with indigestion or inter-scapular pain who are given a PPI or a heating pad instead of a stress test and condolences to those who are anemic and are given FeSO4 as their renal function passes stage IV.
Who else is sick to death of the phrase "practice to the too of our training?"
ReplyDelete