Disincentivize the mostly ineffective practice of throwing brain dulling meds at all psych problems, if they worked, depression would be down, but its up, after a couple of decades of over-using them obnoxiously. (see Peter Breggin’s work) But its super profitable to write a script and kick the person out the door. …a minute later. One reason a provider will write an RX for mild anxiety, grief and sadness is it pays multiple times more than talking with the person. CMS pays medical providers a small fee to do psychotherapy, but hardly anyone does it because of the lack of good money. They make good therapists with a little training in CBT and supportive therapy. Pay them well and they will do it.
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Medications are there to support the person. Therapy is key, but many people prefer a quick fix unfortunately. Just look at ozempic. People don’t want to eat healthy and exercise. Other conditions such as schizophrenia or bipolar mania are more responsive to medications.
It would help if they stopped allow NPs and PAs to diagnose indiscriminately often leaving people with a misdiagnosis they carry for the rest of their life which is costly.
And prescribers will bill 99214 + 90833 which only takes 16 minutes and nets more than a 90837 which is unacceptable. In this instance it makes an LOT. Even worse, NPs and PAs with no training in therapy (bad training in diagnosing and prescribing) bill the therapy add on code to make more $. It’s legalized fraud and the loop hole needs to be closed.
These changes will cut costs by reducing inappropriate prescribing and billing for something they haven’t been trained in.
Never refer someone to a place that employs a lot of NPs and PAs, they’re just out to make a buck at the expense of YOUR health. Just Check out r/noctor
Remarkable, Jane, how you have a lot of anger and feel you need to trash PAs and NP’s. Outcomes for patients are the same for PA, NP and MD, so they must be trained as well. Now that you mention it, PA’s and NP’s are a good solution to the shortage of HCP’s. Same outcomes, lower cost. No brainer.
Outrage because it’s literally killing a lot of people. NPs in particular are terrible, they’re just money hungry. It’s obvious they just want to take a short cut to practicing medicine and dgaf about actual quality care. Outcomes are only the “same” in NP and PA journals with studies designed to produce a certain outcome, ex: NPs manage UTIs, URIs and other simple cases vs MDs manage complex patients with DKAs , decomensated HF etc and then whammm NP>better because they have less hospitalizations.
I can link you dozens of studies from actual REPUTABLE journals and organizations from JAMA, lancet, AMA showing NPs and PAs order more unnecessary antibiotics, narcotics, opioids, benzos, labs, imaging, poor quality specialty referrals, unnecessary costly biopsies, etc meaning they in fact cost the patient more, bring more business to the hospital system, and they get to pay them less…all the while the patient often thinks they’re being seen by a doctor.
Most of these NPs diploma mills have a near 100% acceptance rate with minimal experience requirements.
The public is waking up, r/noctor is growing.
You even find NPs and PAs who decline to be seen by anyone other than an MD it’s ironic.
NPs and PAs were created to help with the shortage in rural locations and other locations without access to providers. The problem is most aren’t living up to their word and practicing in those areas. Many aren’t accepting Medicare or Medicaid because it’s all about the money, not the patient.