tag:blogger.com,1999:blog-6076839327674215825.post2263663098713309347..comments2024-03-27T05:14:34.288-04:00Comments on Medinnovation And Health Reform: Can Innovation Save Primary Care in its Present Form ?Richard L. Reece, MDhttp://www.blogger.com/profile/03446550629857699574noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-6076839327674215825.post-19972988927222461072020-08-05T11:05:09.981-04:002020-08-05T11:05:09.981-04:00balenciaga
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christian lou...<a href="http://www.balenciaga.us.com" rel="nofollow"><strong>balenciaga</strong></a><br /><a href="http://www.air-jordanshoes.us.org" rel="nofollow"><strong>jordan shoes</strong></a><br /><a href="http://www.jordan12.us.com" rel="nofollow"><strong>jordan shoes</strong></a><br /><a href="http://www.louboutin-shoes.us.com" rel="nofollow"><strong>christian louboutin outlet</strong></a><br /><a href="http://www.jordans.net.co" rel="nofollow"><strong>cheap jordans</strong></a><br /><a href="http://www.chromeheartstoreonline.com" rel="nofollow"><strong>chrome hearts online store</strong></a><br /><a href="http://www.nike-airmax2017.us.com" rel="nofollow"><strong>nike air max</strong></a><br /><a href="http://www.supremesclothing.us.org" rel="nofollow"><strong>supreme clothing</strong></a><br /><a href="http://www.nikexoffwhite.com" rel="nofollow"><strong>off white nike</strong></a><br /><a href="http://www.supremeclothings.us.com" rel="nofollow"><strong>supreme</strong></a><br />yanmaneeehttps://www.blogger.com/profile/15229165146687805497noreply@blogger.comtag:blogger.com,1999:blog-6076839327674215825.post-4136753888262586252008-11-28T18:15:00.000-05:002008-11-28T18:15:00.000-05:00RN Forever,You start by saying stop the belittling...RN Forever,<BR/><BR/>You start by saying stop the belittling language then spend 6 paragraphs scolding me and belittling MY education and training. You know nothing about me but I now know more than I want to know about you. You have not answered my question and have added nothing to the topic. Your call for cooperation and respect rings hollow after 6 paragraphs of insults.kevinh76https://www.blogger.com/profile/01983254281604124576noreply@blogger.comtag:blogger.com,1999:blog-6076839327674215825.post-2287447736688373662008-11-28T12:47:00.000-05:002008-11-28T12:47:00.000-05:00Ok Kevin- First stop that belittling language. I a...Ok Kevin- First stop that belittling language. I am an adcanced practice nurse (family nurse practitoner for 15+ years, RN for 35) and I am not 'midlevel' to anyone. I am a registered nurse with 6 years of PROFESSIONAL education (including premed organic chem, micro, physiology, patho phys, 4 semesters of pharmacology, anatomy, dissection, etc.) as compared to 4 years that MDs have. I understand things about patient care efficacy that nurses know and physicians rarely consider (family, community, and financial issues among them). <BR/><BR/>I do not need a physician manager and am very fortunate to work in a state where I do not have mandates for that expensive nonsense.And as far as malpractice? Get your facts-NPs are sued far less than MDS for many reasons-among them is that patients TRUST us, we care about them, AND our quality of care is excellent! In states where I practice independently, no physician will be sued for "managing" me (The data on PAs who ARE mandated "midlevels" with physician supervision in all states is quite different!).<BR/><BR/>I love doing the work physicians are "fleeing" and I don't mind make $70,000+/year-that is plenty to give me a very nice life, although I do not drive a BMW, Mercedes, Lexus, or Audi like most primary care MDs in my area. <BR/><BR/>Furthermore, my patients and I need physician specialists, just like you and your patients do, for referals for care that is beyond our capabilities-no question about that. But I do NOT need a physician to supervise me for standard daily routine primary care tasks-nor do you and I bet you refer to specialists all the time (or you should-if you don't you are practicing shoddy medicine). <BR/><BR/>Now, for a history lesson. Physicians have not filled the primary care needs in this country EVER. There has always been a primary care MD shortage. The NP movement in the 1960s was designed just for this reason as were public health nursing initiatives as early as 1900. Nurses have often been the professionals filling the gap and done so quite well. Organized medicine (such as the AMA, AANA, ACOG, etc. and others) and certain self serving individual MDs have always opposed nurses doing what nurses know and physicians want to control, and when the 'nay sayers' win, the people of this nation, particularly the poor and vulnerable populations, lose. <BR/><BR/>I'm sorry you chose a path that has you in a position where the world isn't turning out the way you wanted when you were in medical school. But maybe you and other MDs who are threatened should get a grip and see the big picture. Get the facts and get them straight. Stop focusing on your own self interest and think outside your narrow box. Start to care about people in this country and see nurses as allies and colleagues. Cooperation and mutual respect, and physicians who acknowledge nurses' experitse and importance, will make all the difference.RN foreverhttps://www.blogger.com/profile/10596770968177721165noreply@blogger.comtag:blogger.com,1999:blog-6076839327674215825.post-91187195380830587682008-11-28T02:38:00.000-05:002008-11-28T02:38:00.000-05:00When it comes to the role of midlevels as the futu...When it comes to the role of midlevels as the future of primary care, one question always arises in my mind which I have never seen adressed or answered: Why is it assumed that mid-levels will want to do this work that physicians are fleeing, for a presumably lower salary?<BR/><BR/>Additionally, physicians don't go through their training to become managers of midlevels. If you want to completly stop all application for primary care residencies, just tell the current crop of med students that a career in primary care will involve managing an army of midlevels. I will never assume the malpractice risk of supervising an army of midlevels so that I can be sued and held responsible for their mistakes. I have other skills and there is always hospital medicine or concierge practice if the system forces an untenible change that would prevent me from making a living doing what I do now as a primary care internist.kevinh76https://www.blogger.com/profile/01983254281604124576noreply@blogger.com