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The Paradocs Podcast with Eric Larson

The Paradocs is a fun and lively discussion with a couple of docs on the practice of medicine. Occasionally serious, usually lighthearted, and accidentally informative. A show for physicians to learn more about what is going on and a great place for them to direct their friends and family to better understand the challenges they face.

Oct 10, 2019

What's the deal with nurse practitioners (NPs)? Why is there so much anger from physicians and NPs when it comes to how patients are treated? Every day on my twitter feed I hear about how nurse practitioners and physician assistants and others are "acting like doctors without the necessary training" and are "dangerous because they know nothing." Meanwhile my friends who are NPs and PAs cite studies that claim they provide just as good if not better care than physicians because they are more compassionate and willing to listen, etc. Both camps are hogwash.
In reality, this is an argument that is about scope of practice and not about what we should really be discussing - which is patient autonomy and freedom to see whom they want. Physicians and other physician extenders/midlevels battle it out every year spending millions of dollars lobbying in state legislatures and in DC to restrict and expand what non-physicians can do under their occupational license. We wrap these arguments under the guise of it being about patient safety or saving the health system money or giving patients choice when it isn't really any of those things. 
As professionals in health care we have been bamboozled into believing that the only way to run our businesses and health care is by restricting choice and allowing insurers (government and commercial) to dictate to us how much they pay. Because we aren't allowed to set prices based on what we believe our value is in the marketplace we end up with massive regulatory and legislative battles that don't help patients at all.
President Trump, who has issued a number of very helpful executive orders to allow some freedom of choice in the health market, just issued an executive order that calls on the federal government to pay the same for every visit. This means that no matter who performs the visit it will be paid the same regardless of the level of training and experience of the professional seeing the patient. This will undeniably lead to an increased use of NPs and PAs instead of physicians since their pay is less and their revenue will be the same. Ultimately, this is because patients aren't allowed to pay a premium or receive a discount in the marketplace based on their personal choice.
  We continue to allow the empire to decide how we will be paid, who will be paid, and in what way. As long as we allow this we will get the kind of health care we deserve - expensive, lousy, and no patient freedom.


show notes

Non-Profit Hospitals are Making a Killing: President Trump's Executive Order that will lead to 100% reimbursement amounts for any level of health care provider which will inevitably increase the amount of non-physicians taking care of patients. Section 5c is the relevant one to review.

Episode 022: Recent discussion with Dr. Bernard highlighting the failure of government run entities who mandate the use of NPs is not best for patients.

Made Simply Web Site Creations: This is the great, affordable website service that built my wife's podcast site. I cannot recommend this company more to someone looking for creating a website.

Always Andy's Mom: Home of my wife, Marcy's, podcast for parents grieving or those looking to help them.

YouTube for Paradocs: Here you can watch the video of my late son singing his solo on the Paradocs YouTube page.

Patreon - Become a show supporter today and visit my Patreon page for extra bonus material. Every dollar raised goes towards the production and promotion of the show.

Listen to The Paradocs on RadioPublic