And helped anyone out as well as asked for help in every situation. I’ve never declined a transfer nor will I. But when I frequently have NP sending in left upper belly pain and requesting CT for appy rule out you know they either haven’t done an exam or don’t understand a proper eval of abdominal pain.

In my primary location I don’t have any Mid levels that work for us. They are all urgent care or work their own practices. So I have little to no influence over them. I’ve invited the three main urgent care and multiple other mid levels to come shadow us and to do training nights. But they have never taken our group up on it.

The fact that you feel the way you do says a tremendous amount as you as a provider.

You obviously understand what it is to be a provider. The real issue in my opinion is when providers simply don’t care. Either to truly evaluate a person or don’t care to continue learning. That can be for a myriad factors, burnout, maybe they never truly applied themselves or their education is insufficient.

My main concern over the last few years is all of the np students I have had shadow our group seem to care very little about learning and gaining experience. Our group has offered as nauseum to discuss work up, show them extra things, do night training but they rarely want to be engaged.

This is not the case with the hundreds of medical student I have trained and certainly not the case with the interns and residents.

Paramedic students however show the most initiative of any collective group I’ve ever trained.