Btw, Cochrane review found no significant decrease in quality of care when

Mar 6, 2021
6:53:41pm

valleus Truly Addicted User

they compared mid levels to MDs. They did find a significant increase in spurious referrals and lab orders, but no evidence of worse outcomes. I think a lot of us MDs are in denial about what the data is really saying.

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valleus

Bio page: valleus
Joined: Feb 1, 2017
Last login: May 4, 2024
Total posts: 9,427 (2,197 FO)

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Messages

Author

Time

Question for the older docs (I'm mid-40s)

5150man All-American

3/6/21 11:52am

I'm not a doc but that is scary to hear

Parker Schnabel

3/6/21 11:58am

I don’t want to risk getting into a bashing session over mid levels. I think

Idahofallsblue

3/6/21 11:59am

I agree. Funny thing is I never got trained on how to manage a mid level.

5150man

3/6/21 12:09pm

I took my kid to urgent care a couple years ago because he had snorted a marble

LiveCoug

3/6/21 12:00pm

You should be pissed. Nasal foreign body is something any urgent care should be able to handle.

Virginia Ute

3/6/21 12:11pm

I usually had parents mad they brought them to me in the UC when I just had them blow in the mouth and it popped out.

5150man

3/6/21 12:16pm

Urgent cares are the worst. They are good for strep that’s about it.

Fargo

3/6/21 12:13pm

They’re antibiotic dispensaries. That’s all.

doktorpfeffer

3/6/21 1:01pm

That's one I struggle over.

5150man

3/6/21 1:33pm

My urgent care has been spectacular. Worth every Penny. They are no hospital,

RealityCheck

3/6/21 4:47pm

So your vacuum cleaner was broken?

CougarThug

3/6/21 3:22pm

Maybe what you’re seeing is that NPs are trending younger, as it is an

valleus

3/6/21 12:05pm

They’re just churning out so many and so many of them are new and have no experience and they get put in roles that they

Virginia Ute

3/6/21 12:10pm

Sometimes the NP students come "observe" me in the ER

WorfoSAUR

3/6/21 12:16pm

Yeah. Last year I finally said no more.

5150man

3/6/21 12:20pm

NP student here

redraidercoug

3/6/21 12:35pm

I didn't mean to be offensive. Just wondering if others see what I'm seeing

5150man

3/6/21 1:23pm

RE: I didn't mean to be offensive. Just wondering if others see what I'm seeing

redraidercoug

3/6/21 2:24pm

I work in a hospital with some very good NP’s and PA’s. I get the

OmahaThunderCoug

3/6/21 1:30pm

Urgent Cares are the joke.

claw

3/6/21 1:32pm

Several reasons: less financial incentive for quality personnel...

BringYourUltimate

3/6/21 1:40pm

In a different field, that sounds like seasonal tax preparer franchises

dratax

3/6/21 2:42pm

As an Urgent Care physician

hunkahunka

3/6/21 4:19pm

I'm only about 5 years older than you, but I have seen the same trend. I am in

BYU28_Miami21

3/6/21 4:27pm

I'll just say thank you for seeing initial consults. My referrals initially seeing a mid level frustrates me to no end.

5150man

3/6/21 4:57pm

I’ve had a similar experience.

Shovel jockey

3/6/21 5:22pm

I do think the rapid growth in programs is problematic. I was fortunate to train

Nakedbootleg

3/6/21 8:00pm

I’ve never shamed anyone in my career. And I have always answered any question

Shovel jockey

3/6/21 10:20pm

I should mention that I was fortunate as well to train with PA side by side

Shovel jockey

3/6/21 10:32pm

Thanks. You’ll have to forgive me if I get to defensive, but it is frustrating

Nakedbootleg

3/7/21 8:26am

One of the harder things for me

5150man

3/7/21 8:43am

Btw, Cochrane review found no significant decrease in quality of care when

valleus

3/6/21 6:53pm

Seriously though. How did they grade quality or what is defined as a worse outcome?

5150man

3/6/21 7:13pm

I hear what your saying. However in a field in which you

Shovel jockey

3/6/21 7:27pm

my opinion: mid-levels who have direct supervision by an MD do fine. mid-levels who have no supervision are often lost

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