Saturday, September 01, 2012

Nurse Practioners Owning Cardiologists?

Asking the important questions: "Can a Nurse Practitioner open/own a cardiology practice?"
"Technically, I can. The problem is getting a consulting physician to sign on. You aren't going to get a Family Practice MD to agree to that. You're also probably not going to get a Cardiologist to agree to that as you'll be competing with a specialist who might like APNs, but isn't going to give you the piece of the pie that pays for new boats, jet skis, etc."
Yep, it's hard to make this stuff up.



Anonymous said...

An informed patient population would not go for, it would certainly fly in the US.

Lisa said...

If you are sick enough to need a cardiologist, would you want to be treated by a nurse? Don't nurses practice a different kind of medicine than doctors?

Austin said...

Actually, Wes, this OP is exactly right. The 'business of medicine' is where the money is made, and there are many successful practices (both specialty and otherwise) where the majority of the work is performed by midlevel practitioners but the majority of benefit goes to the owners, frequently part-time (or non-practicing) physicians.

You're trying to lump the 'practice' of medicine with the 'business' aspects, when in reality physicians are frequently some of those LEAST QUALIFIED to run a business (even one based on medicine). Hospitals are frequently run by administrators with no actual health-care experience, and how many cardiology practices are successful because of a great business manager (non-physician)?

The point I think you want to make is that it's a bad idea for a nurse practitioner to hang their own shingle and try to practice cardiology without "adult supervision" (for lack of a better phrase.) In that, I agree with you completely (though suspect that in the future the public will be forced to accept a lesser level of care due to reimbursement issues). The ownership of the practice is much less relevant then the standard of care provided.

Anonymous said...

I thought that the 'authority' of nurse practitioners was the physician that they worked with, by law. Doesn't the AMA call the shots, not the PBM? If this is the state of medicine nowadays, then we're sunk, line and sinker. Because, in pharmacy, the pharmacists no longer call the shots; it's the PBMs as well.

Anonymous said...

Well, it used to be that nurses who continued to APN were extremely experienced nurses. I have found that more often than you might think, it's not all nurses moving on who want to be ANP, but people interested in medicine who don't want to pay for the MD track or put the time into the MD track. People who never wanted to practice nursing at all.

I don't know the OP of that posting, so this is not to say that person had this intention.

Some people weigh options of potential earnings and lifestyle and choose ANP as an early goal. In other words, they have no intention of working as nurses - for long. They get their BSN on a fast track, which is expensive but nowhere near that of an MD's edu. Then they begin their ANP as soon as possible. You will find they have almost no clinical time in the role of an RN prior to becoming ANP.

What's scary is that some of these people will say, "I was premed" as if they are gifted LOL, and seem to give you the impression that they are justified trying to pursue their MD "calling" in a less expensive way, a sort of cheaper route to destiny for them. LOL. If you hold them down they will swear they never had intentions... but sometimes, I just see someone with delusions.

The danger difference is that APNs have growing independent power. This is because it was expected that anybody going to APN would have many years working clinical experience under their belt before thinking of making a transition - unlike PAs.

You can game any system, even the MD track. It's up to state boards and the nursing and medical community to vet people. As we all know, not too many administrators really care.

But since healthcare is only a business right now, anybody with some money can start one.


Lisa said...

I have to agree that having nurses hang out a shingle isn't the best idea,having just extracted myself from that situation. Even if a nurse has many years of experience they don't have the same training as a specialist. If you need a cardiologist it means that your problem is too complex to be treated by your primary care doctor. Why would you go to a nurse who has less training and has been taught to view healthcare from a different perspective? Sadly the day is already here where we as patients are being asked to accept that.

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