Bad Doctors & MD’s? Try a PA or NP. Physician’s Assistant & Nurse Practitioner.
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- Опубликовано: 9 янв 2023
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Admit it ITS TRUE thats Evidence based proven DNP/NP and P.A. provides better quality of care. Bullseye!
Literally not true. Actually quite bullshit.
@evankikla3487
Lady it's 2024 not 1980. Grow up. MD is traditional old school wannabe god. Go home
@michaeldallas-yf4gj lol medicine has only gotten more complicated since 1980 but Whatever. It's your health, if you want to rub crystals on your genitals and get "holistic" care from an NP go for it. I'm sure you'll want a doctor when you actually are a frightened patient.
NP and PA have less than half the training of MD/DO
@@everettpannkuk326
Everett3× strikes back again.
THIS IS ABOUT WHO PROVIDES BETTER CLINICAL CARE AND RAPPORT. NOT WHO HAS MORE SCHOOLING.
I CAN TELL YOUR EGO IS AFFECTING YOUR INTELLIGENCE. PLEASE LEARN HOW TO READ!!!
HIGHER LEVEL OF SCHOOLING DOES NOT NECESSITATE BEING MORE INTELLIGENT!
OBVIOUSLY YOUR NOT
I'm a PA and think MDs and DOs have a wider knowledge 100%. Personality plays a big role in who patients will like more, but by default they prefer physicians over APPs.
I think because nurse practitioner and pa are bed side or in primary care face too face and many doctors are book worms studious nerdy lacking empathy and interpersonal skills as academic goals where most likely more important to do well at all levels of their careers 😮
Doctors outshine them on diagnosing and surgical interventions. Doctors go through very rigorous testing and hands on training.
There’s no replacement for the amount of years of training doctors get vs the 1-2 year of training NP and PA get.
The RVU model has the potential to create distrust towards doctors, as it might incentivize them to order unnecessary tests, surgeries, and follow-ups for financial gain.
@@USAMedicalSupply yes that’s true I agree with you. That’s been happening since forever. It also happens with NP and PA.
I agree there’s no replacement for doctors and that there’s a place for each job to fit in to the medical system. But PAs and NPs never have just 1-2 years of schooling. NPs have to get a 4 year BSN and then go through a 2-3 year NP program. PAs have to have at least 1-2k clinical hours before even applying to the 2 year programs.
yes everything you said is correct. What I'm saying is that the 2-3 year programs NP/PA go through do not compare to the 10-14 years doctors go through therefore doctors know more and can do more there is no substitution for the years of school and education @@lalalulu1943
Doctors lack of respect for their peers profession is shown in comments like this, which is what we’re talking about here
Speaking as a patient. I will always take MD/DO over PA.
Thanks for sharing.
Why is that
@lalalulu1943
Anecdotally speaking, met a PA for derm related issues (as dermatologist appointment was not available), the PA was very confident in diagnosis and also absolutely wrong (found that out when my condition did not improve and got an appointment with a dermatologist)
I know that anecdotes are not evidence.
And that's why I said I will prefer MD/DO over PA given a choice.
Wise choice
@@lalalulu1943 Because they arent doctors.
Are you feeling that you need bolstering?
This is not an easy answer.
1. I appreciate those providers that give me their time, expertise, and knowledge.
No matter their title.
2. True Mds are held to a different standard, earned their degrees, and thus meet the insurance equirements.
3. Are True Mds better than other medical providers, no. Except in their specific area of expertise.
Example. Shoulder surgery. My initial visit was with the surgeon. And though it was a short visit I actually received logical information. Though I did not receive details
My next visit was at the office to get set up for a medical device and I met the pac. And I felt he had no care about me whatsoever. He was just fulfilling another prescription. He didn't want to know my answers even though he asked.
On surgery day, it was at the very last second that I saw my surgeon before surgery as I was being wheeled down the hall. Was I assured no. Did I see you the PAC no.
Was my surgery as success? So far it is. Was the PAC able to do that no. Each person has their job to do. My medical assistant and my Pac or the guy that actually walked in with the medical device or my surgeon. And all the nurses that took care of me under surgery and after surgery. All have a very important key role in my recovery. If I had to choose one I would lose the PAC in this situation.
However, my Pac in my primary care? I would choose him every time. He doesn't know as much as he would as a specialist would. But I trust him and he listens to me and he investigates if he doesn't know. That counts as a true medical provider
Here are my thoughts from my personal experiences. In addition to my own care experiences, I’m a Paramedic that reports to MD/DOs, PAs and NPs. Most PAs and NPs that I’ve experienced are younger. Probably because they don’t have to do 4 years of med school plus residency. My current physician is fresh out of Medical school, she is younger than 30. I’ve noticed young providers are MUCH more attentive, regardless of their title. I’ve met old, cranky NPs and I’ve met even older, crankier MDs. I’ve had good and bad experiences with both. In terms of knowledge, doctors will always know more. But healthcare is far more than one single providers knowledge. I’d rather have a compassionate provider that will obtain an answer they don’t know over a rude provider that is extremely knowledgeable. High quality patient care is more than knowledge alone.
Well said! Thank you.
It’s individual…I’m a nurse consultant and hyper specialized…I’m a brain injury consultant for my hospital…that’s all that I do…im a resource nurse for brain injury for physicians and PA-Cs and ARNPs and of course I’ll talk to patients and families…but it’s all I do…I have multiple certifications in that area and most importantly, I’m a survivor myself…so I believe that areas where any medical professional is better is one where they’re passionate and dedicated to making themselves better…it becomes more than a job, but their purpose…so I don’t know if it’s necessarily based on their education, but rather their calling to what they do…
Absolutely not. Physicians carry everything on their shoulders. They are the ones that get sued and blamed if a decision goes bad or someone is misdiagnosed. Midlevels are great personally because they don’t carry that burden and have more time to spend with people.
That’s not true PA/NP also must have malpractice insurance they can also get sued.
@@bryanharrison694 CNAs and nurses carry malpractice insurance too. Guess who usually gets dropped from lawsuits? Everyone but the physician. They are the ones with the highest payout and therefore have biggest target on their back
@@jonfilibuster8499 that’s not true NP/PA can also prescribe medication and work with a considerable amount of autonomy. Np can even open their own private practice in certain specialization areas meaning a physician isn’t always getting targeted especially if they’ve done nothing wrong. It depends.
@@bryanharrison694 Highly recommend you look up malpractice laws and how they work. You are judged by your own 'peers'. Its the blind leading the blind for midlevels right now. Physicians always have the bigger target on their back
Do PA’s and NP’s participate in RVU’s like Physician’s?
PA = Physician Assistant, not Physician's. They are not the physician's assistant.
Do PA'S and NP's ever have a treatment plan that doesn't involve 'senior review' or in other terms a review from a doctor? 🤔
That’s great that a treatment plan involves Senior Review! Nice safety net no matter the title! More reason to trust a PA or NP.
It depends on the specific job and state. In all 50 states in the US, PAs work with a doctor. For NPs, it depends on the state. Some are restricted practice states, meaning they need a physician. Others are full practice states and do not require a doctor for treatment.
@@USAMedicalSupply Right, so ultimate care is still being provided by a doctor. Therefore, just see a doctor.
idk about PA’s but maybe the NP’s who truly started at the bottom, PA’s don’t, they go into the clinical setting only after obtaining a masters degree while the RN is starting out literally at ground level acquiring clinical experience & knowledge, learning management skills, people skills etc… I honestly can’t compare doctors to nurses or NP’s because there simply is no equivalent to the MD. I’m a CRNA, I have the DNAP however I’m no physician anesthesiologist though our work is the same in ways it’s still different positionally. I honestly don’t think about those things, everything is up to the individual in what they do to acquire success. I think ALL of us in every position & scope of the medical field would get along much better if we all just did our jobs the correct way & focused on that🙂
Do you think MD’s should be paid bonuses on an RVU scale like it is today?
Oh, we start at the bottom too. We have to get clinical patient care hours before even applying to PA programs. Personally I got my CNA license straight out of high school. At that time I wanted to be a pediatrician. Found out about PA first semester and loved it compared to a doctor. Did my bachelors, volunteered at Mayo clinic and shadowed while in undergrad, did some CNA work here and there. Once I graduated undergrad is really when I started working. A little over a year as a CNA in a nursing home making like 9$/hr.. switched to hospital med surg CNA after that for the same time at 11$/hr (so 2.5 years total as a CNA). While working as a CNA, I got my EMT license and then got a job as a pediatric MA. I worked there for 2.5 years (12-14$/hr) up until the day before PA school orientation started. Literally finished my shift at 3:30 and then drove 5 hours to my new apartment for school. So I had 5 years full time work in the clinical setting before PA school. PA school is getting more and more competitive and if you don’t have direct patient care hours, your chances of getting in are very low. Most do CNA, MA, scribe. There are others though. Some people this is their second career. Some done in as EMTs, paramedics, physical therapists, etc.
@MHSMagicLuver I personally have will have gone through 10 years of PCT/CNA experience and at least 3 years as a RRT before applying to PA school. Still in the process of getting my bachelors. I figured working as an RT prior would look even better. PAs definitely do work their way up.
You guys know that Doctors aren't like just born right? They start as Med students? You know, paying for the opportunity to do scut work while getting embarrassed by literally everyone in the hospital?
Like wtf do you think the bottom is?
Even when they are doctors in residency nurses are still making more for working less
PAs for sure work their way up. I'm a CNA getting my BSN and still have PA as my goal and so do many of my peers. You need at least 2000 hours of patient care before you can even apply to PA school, and most of us start out as CNAs, EMTs, nurses, etc
It's important to understand that the most important thing is the person and their integrity. I've seen the two extremes. Medical school provides incredible knowledge and training. Healthcare is about collaboration and we've gotta learn how to work more effectively together.
I think it’s debatable that many mid level providers tend to have more life experiences that allow them to form a deeper connection with their patients. Assuming they have had prior clinical experiences such as a nurse, EMT or paramedic.
Based on my professional experience I believe college athletes are better than pro athletes. It’s based on complete flawed thinking.. but it’s just my opinion.
NP’s or PA’s aren’t professionals? You would trust a 1 year MD over a 20 year NP or PA in the same related field? Education holds no value to competent experience.
"1 year MD" is an intern, directly supervised by an attending, and def not calling the shots.
And that 1st year MD has about 3-6x the clinical experience of new midlevels, have better structured and more rigorous academic and clinical experiences, and is just starting theirr specialty specific training.
They used to offer midlevels a watered down version of the step 1 doctor licensing exam and stopped when less than half could pass. 95% of US MD students pass this on their first attempt and that's while being only halfway through medical school.
And the scope of practice for midlevels gets very narrow very quick. 20 years of managing BP medications doesn't make you a better provider than that new attending primary care doc just came out of 3 years of grueling Internal Medicine training. The IM residency at my hospital alternates between clinic and hospital setting every month, and in the hospital it's 12hr days 6 days a week for a month with a 10 patient load. Then there are structured rotations in different medical subspecialties and different hospital wards to learn the intricacies of managing complex patients whether they are in the ICU, Cardiac Care unit, etc. How many of you midlevel providers worked exclusively on a hospital's Infectious Disease consult service to learn the ins and outs of Antibiotic management?
I agree with this video 100%! My primary care doctor is okay, but the nurse practitioner I go to is great!
Absolutely!
There’s no such thing as a “fake doctor” . Whether you are a NP,MD or PA, you are a PROVIDER. I’ve seen so many malpractice lawsuits against doctors who injure or butcher their patients out of lack of competency or “EGO” . Whatever provider works for you, take it! Nice video!
Physicians get sued all the time because medicine has risks and people don't like all thr outcomes. That said, physicians are always going to get sued more because they handle the more challenging and riskier patients and also have the money.
I have limited experience with P A'S However, the ones I have dealt with seem to ask a lot more questions, And possibly be a little more thorough, But maybe a little quick with the prescription pad.
PA’s and NP’s definitely get the gestalt of whatever healthcare setting they’re in better than many MD’s. They more often understand relationships better. My buddy is a hospital CEO with 3,500 staff and reports that 10:1 his patient letters are about positive experiences with their nurse, not their doctor. NP’s are trending toward getting a little big for their britches, imo. But the market/lawsuits will correct whatever financial savings are coming from replacing MD’s with NP’s.
Yeah because thier nurses are at the fucking bedside dude.
Doctors aren't there to check your vitals and document your shits. They are there to make complex medical decisions and formulate and manage very complex treatment plans - oh and they do that for like 10-20 patients at a time. For every 1 minute they spent with a patient they spend 10 reviewing all of the labs, vitals, imaging, and notes left by other specialist or healthcare providers. The amount of stuff a doctor has to so to manage one patient is incredible.
Whereas nurses get to sit on 2-6 patients for an 8 to 12 hour shift and often times the patients are the nicest people in the world and totally stable. Easy to make friends that way.
??? Not a vaild argument. Youre reasoning towards np and pa's sounded like a personal opion and very vague. Then gave no arguemnt towards ur distaste for MD's...
It's subjective, but based on my professional experience and personal interactions, I deal with everyone in healthcare, from MDs downward, daily. I believe the RVU system is the root of all evil with MDs in healthcare. I would choose an NP or PA over an MD any day of the week. I prefer the professional who is more likely to treat the person rather than the education they have acquired.
I wonder if it has to do with the type of education itself. Medical students and residents are out through hell. It makes sense that after that accomplishment they’d feel entitled to a bit of arrogance and ego. When they’re at the top of the medical system bringing home 250k+ and are in charge of everyone else, it makes sense. They’re also more disease focused and less patient focused which can be both fortunate and unfortunate.
Yeah waayyyyy wrong bro...
First, "outshine"? In what? The only thing they are good at is humoring patients more because they have easy patients and reasonsble workloads - unlike doctors.
Second, nurses and PAs start at the bottom? 😅😅😂😂😂
Wow.
Theres nothing lower than an Med student which is where all the docs spent 4 years getting shit on by literally everhone. Then you go to residency where you worke sometimes 80hrs a week for years, making less than the nurses, and still getting shit on by everyone. Residents are literally the most abused employees in all of healthcare.
And patient seen by MDs return back frequently cuz they were misdiagnosed or underdiagnosed.
Get ur shit together lady. ITS TRUE!!! Who's mid-level now you!!!!
ITS EVIDENCE BASED PROVEN DATA ALREADY POSTED. GEEZ. UR EGO IS HIGHER THAN god!!!
Nothing lower than a med student? What’s the difference between them and a PA student?
Go enroll to insecurity 101
@croatiangambler8059 well med students have to work much harder, for much longer, just to get into residency where they still spend manh more years essentially at the bottom of the totem pole in the hospital. Between medical school and residency, physicians spend between 7 to 10 years in a supervised status versus 2 years for NPs and PAs. When you are a medical student or a resident the hospital sees you more as a liability than anything (despite the fact they are subsequently desperate to hire you when you become an attending). And everyone in the hospital knows this, and treats you as such.
@michaeldallas-yf4gj the only people who are insecure are midlevels who can't admit what is self evident, they are not doctors and can't do what physicians do.
Yes.
The only people who say otherwise are the mid-level providers themselves. Dunning Kruger effect.
Your theory doesnt work. MD's start out as med students, which is one of the lowest positions. After that, residency in which you get absolutely destroyed. Then if youre done, you start at the bottom again during fellowships.
💯
Yes!!!!!!!
To those who raised the differences in education as an objection, I’ve been on rotations and my fellow med students get schooled all the time by PAs at clinics. Why? Because they do this for a living, they do actual medicine and have done it for many years. There’s no substitute for actually doing medicine as your career. Experience is the best teacher. That’s why physicians are good at what they do, because of the years in residency working 60-80 hours a week, not because they could vomit out the Krebs cycle 30 years ago.
But a PA can be great as well, like the PA I saw who had 20 years of experience. Her SP with 30 years of experience admits that his PA knows just as much as he does, if not more because she attends all the conferences and webinars and reads up on every diagnoses she sees on top of having 20 years experience, whereas the doc admits he hasn’t kept up with the latest knowledge and has forgotten 90% of the pathophysiology that he learned decades ago, but gets by on his experience alone.
Am I saying every SP-PA is like this? No. But it’s not always black and white and the takeaway here is that experience is ultimately what matters most. Yes, they came out of school with fewer hours than an MD/DO, and while they need to consult their SP a lot when they begin their career, at some point they will have a lot of experience of their own and eventually become nearly autonomous providers of their own, with the SP thing being more like a mutual agreement on paper. From what I’ve seen in actual real life, a seasoned PA and an MD are practically indistinguishable apart from the two letters on their coat.
I agree with you, however, I would say surgery is the exception. No more how seasoned a PA is, they will forever be first assist in surgery, as the physician has full autonomy & will therefore have the PA assist with suturing, suctioning, and retracting. I however am interested in physical medicine & rehabilitation. I’ve just been contemplating whether I’m wanting to be the physiatrist or the PA. It’s a hard choice because my girlfriend & I have talked about marriage & kids in addition to wanting careers in medicine.
@@danielsanchez3260 Agreed. No argument from me. As far as your career choice, a common theme I've seen from older people is that we should choose family over career. So make of that as you will.
I’m a PA and I love it! I will say though we are all good in our own way. We have some great PAs as well as NPs, MDs and DOs and we also have not so great PAs, NPs, MDs, and DOs. It all depends on the specific person. Also I did not go into this field to replace physicians. But I’ll say, my first job was in family medicine and was not a fan. I shadowed a NP for two days and then I started seeing 14 patients on my own the next week. Definitely think we need more on the job training as a new grad right out of school (just as physicians have internship and residency). Some of my patients only wanted to see me. Some patients didn’t believe me when I told them something about their meds needs to be changed (specifically her thyroid med dosage) so she went to go see a physician about it. The physician re did her labs and told her the exact same thing I did. But yeah it all depends on the specific person.
There is no healthy wine.
Go on, I’m listening….👂
This is just silly. From my experience the moment you start asking the WHY behind everything/pimping NPs and PAs will start to fall apart. Although, PAs are taught under the medical school model, they still crumble. Midlevels attain a lot of pattern recognition knowledge throughout their years, but their curriculum doesn’t dive deep into exactly why everything happens, especially NPs, one look at their curriculum and you’ll laugh, they don’t even get taught anatomy enough to first assist out of NP school.
Maybe a seasoned PA can go toe to toe with an intern or M4, knowledge-wise, but that is it. You have to remember, an MD/DO will have achieved the gold standard of education in healthcare when it comes to being a provider and around 20,000 hours of PCE by the time they’re attendings. PAs will only have ~2,000 hours, and NPs will have a mere ~500 hours. Midlevels tend to get caught in the trap of not knowing what they don’t know, which leads to dangerously high confidence and ignorance.
Overall, midlevels are competent when utilized properly, but dangerous when not (aka wanting full autonomy). If PA/NPs took USMLE Steps 1-3 they would utterly fail.
Lol
You were on to something until you tried to convince people that a seasoned PA who practiced REAL medicine for decades is worse at their job than a literal med student. This is not reality. I’ve been on rotations and my fellow med students get schooled all the time by PAs at clinics. The fact is, there’s no substitute for actually doing something as your career. Experience is the best teacher. That’s why physicians are good at what they do, because of the years in residency working 60-80 hours a week, not because they could vomit out the Krebs cycle 30 years ago. But a PA can be great as well, like the PA I saw who had 20 years of experience. Her SP with 30 years of experience admits that his PA knows just as much as he does, if not more because she attends all the conferences and webinars and reads up on every diagnoses she sees on top of having 20 years experience, whereas the doc admits he hasn’t kept up with the latest knowledge and has forgotten 90% of the pathophysiology that he learned decades ago, but gets by on his experience alone. Am I saying every SP-PA is like this? No. But it’s not always black and white and the takeaway here is that experience is ultimately what matters most.
@@LorianandLothric I meant with medicine in general, not their specific specialty they’ve been in for so many years. Of course if you ask a seasoned PA about their sub specialty and compare that knowledge to an MD student they could go toe to toe, that is if they’ve kept up with their knowledge properly. I know some providers who just get lazy and rely on pattern recognition. The fact of the matter is, MDs and PAs will be the most knowledgeable typically right after their didactic years. Then they start to specialize in wherever they decide to work in, or get a residency in for MDs, and the details about other specialties starts to get foggy later on. That is why MDs take step3 during their intern year or the year after.
I’m a PA. Docs go through border line abusive training for years and paired with the stressors they face from the system and an already size-able ego most of them don’t interact with patients well. Some of course are amazing. PA/NPs start working sooner and tend not to be as ego driven so patient interaction / human connection tends to be better. When your bedside manner is good and you listen well your care is better and patients feel better taken care of. And it’s Physician Assistants, not Physician’s Assistant (we cringe at that). Well now it’s Physician Associate, but that’s gunna take some time to popularize
Thank you JT!
Take STEP 1, STEP 2 and STEP 3 and then get back to me about your education providing decent care
@@Max-bi8fnso let me ask you a question. Who can treat a pt in the ICU better? A Dermatologist, MD or an ICU nurse whose been at it for 3-4 years?
@@stanleygeorge1793 neither eventually. ICU is complex organ failure requiring the know-how to not just treat symptoms but to diagnose and manage accordingly. U gotta understand tachycardia and hypoxia, which probably many to most ICU patients will have, can be from a thousand different things requiring a thousand different combination of medications and interventions, and any mistake can result in death. Fyi as a med student who is finishing his last day in the ICU today actually lol, I’ve seen plenty of ICU nurses with decades of experience still make mistakes in recommendations not to their fault but bc they aren’t diagnosticians
@@Max-bi8fn and I've seen plenty of ICU nurses with decades of experience suggest and make recommendations to doctors, and make life saving corrections to doctors... Here's what I will tell you, when you get into the profession you will realize that everything is really about teamwork. The objective is the improved outcome of the pt. It will not help you to tout your degree wherever you go, especially if you work in IM/Pulm/FamMed... I think there are things all three professions can learn from each other. That's the way we are headed anyway
I prefer DOs then MDs then NPs. I do not trust PAs
Doctors hate PA's in the UK
no
Nurse Practitioners has the most experience of them all. And Nps are well rounded in all areas of medicine. Thank me later.
Found the nurse practioner, go make some tea for the real doctors
I’m sure the pharmaceutical reps have plenty of tea and juice for the doctors!
scam
Yeah you’re wrong. Get a NP or PA to do your surgery.