Covid left us with a staggering shortage of primary care providers. Nurse practitioners are trained and educated to fill that role. 32 states allow independent practice of nurse practitioners but yet there is a 20% paid disparity from that physician colleagues. We need to make independent practice of nurse practitioners, universal and since they are doing the exact same job as their physician counterparts, we need to get paid the exact same way. Therefore insurance companies should not be making insurance payments based off degree .
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Petrina Dennis
Occupation: Nurse practitioner
Hometown: Sterling, Va.
âRecently, I heard a physician say to a young friend of mine, `If you plan to go to medical school today, you better do it because you are passionate about the field. You canât go into it for the money anymore.â I donât think that you would ever hear a comment like that made to someone who planned to be a nurse practitioner.â
âThe qualities and characteristics which drive our profession are passion, commitment to caring for others. Victimization of patients and reliance on an already overburdened system should not be the goal. I didnât even know how much nurse practitioners made when I started on this quest back in 1972. I always knew that I would be able to support myself and my children. It didnât matter that I was never going to be able to afford a Mercedes.â
âThere was a period for ten years that I received no salary increase at all because the doctor/owners had to âcut costs.â This was during the advent of managed care. Yet, they lived in 10,000 square foot houses, took vacations to exotic places and drove top-of-the-line cars. Am I disparaging doctors? Hardly. They deserve to reap the fruits of their labor. But the situation has empowered me even further in the pursuit and fulfillment of this passion to provide the highest quality of services to my patients.â
HYPERLINK âDoctor shortage: Who should fill it? - Jaimee Givens (1) - CNNMoney.comâ Doctor shortage: Who should fill it?
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Norman Salas
Occupation: Lieutenant, South Florida fire-rescue department
Hometown: South Florida
âI am a currently assigned to an advanced cardiac life support rescue unit. I am also an EMT/paramedic instructor. I cannot begin to tell you how many people call 911 in lieu of going to the doctor, sometimes just to make sure their blood sugar is normal, their EKG is normal and their vital signs are normal.â
âMany times they call because they donât have insurance. Other times people just want to get a clean bill of health but would rather not deal with long waits at the doctorâs office. So they call 911 in lieu of the doctor for non-emergency calls, which is often referred to as âabuse of the 911 system.â Of course this is not a very smart approach as we are limited in what we can do out in the field. The prudent thing is for them to be checked out in a hospital where more detailed exams and diagnostic tests can be performed.â
âWe make them aware of this, but they still end up refusing transportation to the hospital based on ânormalâ exam findings on the scene. Itâs sad to not have insurance and rely on paramedics to give you some peace of mind. I hope we never give these type of patients a false peace of mind and that they do follow up with their primary care physician. I donât know the answer. What I do know is that I have a duty to act professionally on the scene and help the patient in whatever way I can.â
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Daniel Purdom
Hometown: Kansas City, Mo.
"As a family doctor for twenty years and now the medical director of a community health center, I believe using mid-level providers to replace primary care physicians will simply continue to increase the complexity and cost of our system. Nurse Practitioners may refer up to 1/3 of their patients versus about 1/10 for family practice doctors. Two visits to take care of a problem and more specialists means more expensive care and no better outcomes. "
âI think the natural path will be importing our primary care docs from overseas, as we do with many of our nurses now. As fewer U.S. medical students are going into primary care, we are already seeing increasing numbers of international medical graduates are being accepted into family medicine residencies.â
Evan Lewis
Occupation: Hospitalist
Hometown: Kingsport, Tenn.
âWe are running into a shortage of primary care doctors. I just closed my practice. Half a dozen other primary care doctors in this small town have closed their doors in the last two years.â
âThe concept is that physician assistants and nurse practitioners should be able to take care of patients with simple problems, but in reality they are often filling exactly the same role as physicians.â
âMany physician assistants and nurse practitioners are very good at their job, but the fact is they are less likely to recognize rare diseases and symptoms that might suggest a serious underlying condition. They (also) do not take any legal liability for their decisions. Instead the liability is passed back to the physician who employs them. And yet many of them get paid nearly as much as primary care doctors. What a deal!â
" I think there is a role for these positions but they should not be considered the answer to a shortage of primary care doctors. Incidentally, many of them find they make more money if they work for a specialist and move away from primary care."
Bernardine Amadi
Hometown: Atlanta
âMy experience with an outpatient office visit was one to two hours wait in the doctorâs office, another 30 to 60 minutes in the exam room, and a whopping five minutes for the doctorâs exam, diagnosis and treatment. Most of the time, the prescription is written before they hear your complaint.â
âThree years ago, I went for an office visit and was seen by a nurse practitioner. She spent 20 to 25 minutes for my annual physical and actually listened to me before writing a prescription. Since then, I have never seen a doctor except if I did not have an option of seeing an nurse practitioner.â
âAnother incident involved my son who was seeing an orthopedic doctor who was working with a physician assistant. I had a concern that the bone scan involved some radiation exposure but the physician assistant working with the doctor ignorantly informed me that the bone scan does not involve radiation exposure.â
âI think that nurse practitioners have more knowledge because of their previous training as registered nurses before they get their advanced nursing education. They are more experienced, confident, familiar with care, have bedside manners and empathy and therefore should be utilized more. They should be given an opportunity to fill (the gap) left by the shortage of primary care doctors.â
Michael Heck
Occupation: Medical student
Hometown: Tampa, Fla.
âThe shortage should be corrected. As a medical student, I can tell you firsthand why there is a primary care shortage. They donât get paid enough. Why would I go into a field that makes 50% of most other medical fields and has ten-times as much paperwork?â
âThe simple answer is that primary care salaries need to be increased. The more complicated answer is that the entire physician payment system must be reworked. Physicians are currently paid for an âoffice visitâ every time they see a patient. So they must see more patients per day in order to keep the office open.â
âThe result? Doctors running late, patients angry, and short office visits where problems are not addressed correctly. Sound familiar?â
âWhile I agree that mid-level providers are an important part of our health care delivery system, they are NOT physicians. When all is said and done, I will have undergone 11 or more years of medical training. Mid-levels, while skilled, do not posses the same breadth of knowledge as physicians and display varying levels of skill managing complicated patients. Also, mid-levels have been known to miss diagnoses. How would you feel if your child had worrying symptoms, but the nurse practitioner diagnosed her with `the fluâ only for her to die of a bacterial infection weeks later?â
âI would be in favor of granting mid-levels expanded duties in true health shortage areas. A better solution would be to increase doctorsâ salaries in those areas.â
Sumin Shah
Occupation: Family physician
Hometown: Naperville, Ill.
âI am a family physician in Illinois and feel the impact of high overhead costs to run a medical practice. Combining that with low reimbursements will cause financial problems for primary care offices.â
"I completely understand that specialists have more years of training than me, but to have an income four to five times that of mine for the rest of our careers is ridiculous. The problem is Medicare which dictates what private insurance companies will reimburse.
âIncentives for medical students to pursue a career in primary care by helping with student loans is not enough to change this trend in which less than 10% of medical students are going into primary care. Medicare needs to restructure the reimbursement system now so current family practitioners, internists and pediatricians will have higher pay.â
âRegarding nurse practitioners and physician assistants, I donât feel they should be relied on to the same degree as physicians. My training for medicine involved a very intense 12 years. A PA has 2 years of training that is much less intense. I have worked with many NPs and PAs and believe me they need advice from their supervising physician more often than not. Mistakes are made by the ones that not consulting with their supervising physicians. It is simply a matter of the intensity and length of our training that clearly separates us from an N.P. and P.A. Working 80-100 hrs/week in residency teaches you a lot.â
Doctors are always completely against NPâs and independent practice. Iâve read your reviews about your 11 years of college. Well Iâve had nine and 16 years at the bedside while doing so I have over 3000 patients in my panel and I never rely on a physician for oversight or for questions. In fact, I had one patient who is a type one diabetic who said that sheâs been going to the Joslyn clinic in Boston for 52 years and I treated her diabetes better than they were ever able to do. she went from taking 64 units of insulin daily to taking 12. I only refer to specialist when it becomes out of my scope of practice. I have diagnosed very rare diseases, and I have a more naturopathic approach. Einstein, I seldom order antibiotics because I know not only does it damage the gut it also causes depression. So all you MD are loathing upon NP. My outcomes are better than yours across the board.
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Healthcare workers should be recognized nationally since we take a national exam, with that we need to be compensated appropriately. Stop paying actors and professional sports millions and give back to what really counts, lifesavers!
Or goto medical school.
- no one would go to medical school anymore. Why do 4 years of medschool, 3-7 years of residency, and 1-3 years of fellowship if you can do it all in 2-3 years as an NP while working full time?
- employers hire NPs because theyâre cheap labor and patients think theyâre seeing a doctor. Why would they hire and NP if they would have to pay them the same?
I donât think you thought this one through