Not surprised. I have personally experienced this. The NPs misdiagnosed me with sore throat and sent me home with nothing. I kept insisting that it’s a peritonsillar abscess (for reference I’m a dentist by training). I told the NP that this needs to be drained asap. He insisted that I’m wrong and it’s merely a sore throat. Within 12 hours I ended in ER and the ER physician had to put an incision and drain it!!

Also the NP falsely represented himself  as “Dr” - he had a DNP.
He conveniently forgot to mention that he is a nurse practitioner!!

This needs to stop.

Im a junior resident in a surgical subspecialty. Its not that these "practitioners" can't think about differentials - is that they don't know even the very basic diseases. I see referrals all the time for Carpal tunnel that is cubital tunnel, or radiculopathy. Basically any hand problem gets a diagnosis of "carpal tunnel." Patients with chronic back pain are constantly referred to spine clinic without any surgical indication.

Thank you for another excellent, informative video!
Shared.

It would be nice to not have to go to urgent care. However, the waiting time for my family doctor is over six months. Due to a shortage, many other doctors in my area have wait times of 1-2 years. Bad care is better than no care.

Yes I noticed this in me choosing to closely examine medical residents

And all Americans receiving health insurance

This is an excellent and accurate discussion.

You guys are my heroes😊😊😊.  Also a couple thoughts. If the malpractice claims against nurse practitioners has increased 42%, but it has only decreased for physicians by 3% and there have been 200,000 nurse practitioners full practice authority roughly speaking added to the workforce in the past let's say 5 years then wouldn't you see a corresponding decrease in physician malpractice suits by 20% and not 3%?  Also, If the AMA is concerned about scope creep why aren't they addressing when full practice authority nurse practitioners practice out of their scope. For example in Florida if they're only supposed to be doing primary care but they're not doing just primary care how is that not practicing outside of their scope/licensing and why isn't the AMA targeting that. I think that with the insurance changes happening in Michigan where I believe one of the insurance companies is forcing nurse practitioners to bill under their own NPI there's going to be increased auditing scrutiny on whether or not they were truly practicing within their scope and that is going to unleash a world of trouble.

Are NPs and PAs held to the same standard of care as physicians in the ER and UC especially if pts are billed as if care was provided by MD?

These Practitioners are a waste of time.  They are an adjunct to the Physician.  They are not doctors.  I do want them conducting assessments  or developing a plan of care for my health ailments.  Their ideas of advance training  fails all criteria. They lack the core requirements i.e. well rounded practical patient. Care in med. Surg. OPHTH.ORTHO PEDS.OOBS. ER ALL SPECIALTY PT. CARE REHAB. ADULT NP WHAT DOES THAT TITLE MEAN WHEN. YOU LACK THE PRACTICAL TO VALIDATE YOUR PERFORMANCE???THE PT. IS ALIVE NOT SOMRWHERE IN YOUR TEXTBOOK

Are NPs and PAs taught and practice using the basics of diagnosis (i.e., Bayesian approach) and aware of the various cognitive biases that may interfere with proper dx?

Unfortunately, we disagree. There is a place for urgent cares to bridge the gap between PCPs and EDs. We don’t want PCPs being overworked or EDs to constantly be overbooked/inundated with patients all the time. So urgent cares do help lessen that burden. We do agree that the triage has to come with the patient which is a lot of responsibility. Dr Long has discussed on our podcast how he tries to teach the patients when to ask for PCP vs UC vs ED.

In a perfect world, all medical clinics and hospitals would only employ physicians but there are just not enough to go around and NP/PAs are paid much less, so more profits for the employer.

There is a current MedSpa case in Texas that our podcast discussed where the supervising physician is currently on trial for a wrongful death of a patient and he never even set foot on site. Urgent cares function similarly to medspas in that they do require in most states a medical director which means the liability all falls on the physician, the one with the deepest pockets. This is a good conversation, wish we could speak about it more openly without push back from NP/PA/admin. Thanks for a good episode!