It would behoove you to bother to do a bit of research before going off and an emotionally driven tirade in which you sputter out unfounded doubt as though it were somehow based in reality. According to The Journal of the American Medical Association (JAMA – linked above), “In an ambulatory care situation in which patients were randomly assigned to either nurse practitioners or physicians, and where nurse practitioners had the same authority, responsibilities, productivity and administrative requirements, and patient population as primary care physicians, patients’ outcomes were comparable.”
The authors (including four MDs) began this study insisting that previous research “did not measure nurse practitioner practices that had the same degree of independence as the comparison physician practices, nor did previous studies provide direct comparison of outcomes for patients with nurse practitioner or physician providers.” Their conclusions, however, have paralleled all previous and subsequent research which indicates that there is no difference in pt satisfaction and pt outcomes (see the slew of similar articles provided following the abstract – all from well known and professionally respected journals such as JAMA).

You are probably right about the seaweed though.

They remind me of the “articles” that state that seaweed cures cancer. I’m not doubting there is an article that says it, but I do doubt their information gathering techniques and interpretation of data (that is probably flawed to begin with).

Tell me, do you approve of the retail clinic model that uses physicians instead? It would seem from your statements that you wouldn’t have an issue with those since the the gods — err — physicians staff these and would magically detect all of the “subtle” signs and symptoms that you purport NP’s & PA’s are incapable of detecting.

I’d be more than happy to point you in the direction of the research that compares patient outcomes for NP-directed care to physician-directed care. (To summarize, the care and outcomes are equal or better).

I just don’t understand your opposition and your physician-centric mindset. Aren’t we members on the same team where the focus should be on the patient as the center of universe??

Wal-Mart is about saving money and customer service, and if they simply read the available literature, they’re going to see that if they want to reduce malpractice claims, customer service is key.

He’s also wrong in that he thinks a lawsuit will cause Wal-Mart any concern. They play hardball, and everyone knows it (they were once hit with a multimillion fine, subsequently withdrawn, for failing to produce documents in a case, and that only exemplifies their scorched earth tactics). Plus, they’ll be self-insured so it will be their money, which they don’t easily part with.

How is this any different other than the fact that this relates to clinic and not outpatient surgery?

You have a group of self referring, inadequately trained (for all situations that could arise) group of midlevels who are skimming off the easy cases to get good results.

So when can we expect congress to come after these clinics?

DermDoc, fairness has no place in business or medicine.