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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: Lane3 who wrote (25571)	4/5/2013 12:45:45 PM
From: i-node	2 Recommendations Read Replies (3) \| Respond to of 42652

>> We shouldn't authorize NP's to perform procedures that require greater qualifications but, for those that don't, it doesn't seem right to pay them less than someone over-qualified. Fine, let NPs clean the wax out of people's ears. But it is insane to tell insurance companies they CANNOT pay a doctor more for an office visit than they would pay a NP. To suggest, for a microsecond, that a visit with the NP is the same as one with a physician is crazy. The education and training a NP receives simply does not give them the expertise a physician has. There are holes in their knowledge you can drive a truck through. You don't deal with a shortage of doctors by encouraging people to NOT become physicians.

To: Lane3 who wrote (25571)	4/5/2013 1:19:34 PM
From: skinowski	Read Replies (1) \| Respond to of 42652

It is human nature that if the only tool you have is a hammer, all problems will tend to look like nails. What the brain doesn't know, the eye doesn't see. I'm sure there are many nurse practitioners of great knowledge and integrity, but - often enough, many will be cutting some corners. They will be missing things and taking on problems above their expertise more often than docs do. I haven't read the frequently quoted studies about the "outcomes" being very close between docs and nurses - but that doesn't surprise me. Most of the time, if you follow advice coming from your neighbor's wife - you'll do fine. The difference is not in the 93-95% of cases - it is in the last 5 or 6%. That's where you get your money's worth. And - the key is to know when a "routine" looking situation is, in fact, treacherous. Again, if your brain doesn't know it, you won't see it. A study based on 100% of clinical situations may not find a statistical difference.... because in the majority of cases there probably isn't any, especially if your "outcomes" are sufficiently short term But, hey, what do I care. We can talk until the cows and sheep come home, and it will make exactly zero difference. Politicians will still do whatever they want, and support their decisions by data produced to order by ivory tower "experts".