from a recent freakonomics episode
http://freakonomics.com/podcast/nurses-to-the-rescue/
>ROSALSKY: The main argument against allowing NPs to practice independently is that they have less training than physicians. But there’s a mountain of empirical evidence from randomized trials, case studies, systematic reviews, and analyses of malpractice claims in states where similar legislation has already passed that all points to the same thing: when it comes to primary care, NPs are just as safe and effective as doctors.
there are links in the transcript.
Believe it or not, most infections will clear up with anti biotics. I get a painful infection every 3 or 4 years that require them (less often when I was younger), hardly someone you would consider abusing them.
Sort of. What people in this thread refer to when they say nurses should do more "doctor things" is a nurse practitioner:
https://en.wikipedia.org/wiki/Nurse_practitioner
If you needed an experience ranking, it would look like this:
CNA -> Registered Nurse -> Nurse Practitioner -> MD
(think of an MD as a commissioned officer in the military, whereas a nurse practitioner is a non-commissioned office who rose through the ranks but is still slightly below a commissioned office in ranking)
Source: Mother was a registered nurse
TL;DR Leveling up nurses around the country to "nurse practitioner" and having them take on more traditional doctor responsibilities is a solid path to success versus churning out more doctors overloaded with debt
"Oh you have a sore throat. Let's do a strep test. Oh it's positive here are some antibiotics"
1. https://www.hopkinsmedicine.org/news/media/releases/study_su...
Any hard research showing this? Something that addresses confounding factors, overburdened doctors, etc.? Is there a study showing that spending 30 minutes with a physician is equivalent to 30 minutes with an RN or PA for all outcomes (not just death)? I have a feeling we're all acting like medical experts in this thread even though very few of us are. It's like when we see research about programming methodologies and are able to poke so many holes in the study it becomes swiss cheese.
Probably not. Or, better stated, not that I am aware of.
Let's think. Seeing a doctor instead of a PA is associated with better outcomes if, and only if, your condition can benefit from the doctor's specialized knowledge. That means it requires treatment, the treatment is time-sensitive (i.e. worse outcomes if there's a delay), and there are significant adverse effects in case of a lack of appropriate treatment.
The problem is, these conditions are either too rare to be studied in any meaningful way, or the patients' very obviously sick and taken directly to the hospital, where he is obviously seeing a doctor and not a PA.
A lot of people go to the doctor for pretty benign ailments which don't really require a treatment, or for conditions that any intelligent, motivated patient is theoretically able manage himself without a doctor. Examples : virus infections, sprains, acid reflux, chronic conditions like hypertension, diabetes, and so on. E.g. : someone has type I diabetes, understands how and when to give himself insulin, checks his feet for infection and so on. In a case like this, the doctor can barely bring any plus value apart from ordering the regular blood work.
Another frequent scenario is when the patient does have a time-sensitive, treatment-required condition, but does not follow the treatment. Again, him seeing a doctor is unlikely to result in any appreciable benefit.
With respect to that comic, I would've gladly paid $4k out of pocket for a diagnosis. I still think fondly of the doctor who quickly figured out the puzzle that tricked a couple other specialists, my PCP, an urgent care doctor, and an emergency medical doctor. The same doctor who quickly sent me to the hospital in an ambulance with a note on my chart that said "this is serious, don't send him home until you confirm my diagnosis."
"Okay... I guess Bob the EMT over here, he's a physician!"