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March 5, 2008 |Permalink |Comments (2)

Doctor, Doctor-- Give Me the News

Here is a sample comment posted on a mostly doctors-only discussion thread. The term "midlevels" refers to nurse practitioners and physician assistants.

"Is it my imagination or is the line between midlevels and physicians in office-based practice becoming nonexistent? FNPs can practice without a doctor on site, as long as one is available to back them up and sign their charts. They can bill using their own UPIN numbers, and Medicare reimburses them at 85% of the physician rate. In my community, some list themselves with physicians in the Yellow Pages under Family Medicine. Some are busier than the FPs. And a few don't correct their patients when they refer to them as 'Doctor.'"

Comments ( 2)

Something tells me the doc who wrote this isn't going to encourage the research project that it begs for comparing outcomes of patient care from the docs and, don't ya just love it, midlevels.

Posted by Judith Shapiro
March 5, 2008 9:04 AM

As a "mid-level practitioner", or my personal favorite, "physician extender" of 20 years there is nothing new in this physician's list of fears. The reality is NPs (Nurse Practitioners) and physicians are meant to be complimentary not exclusive of one another. In my 2 decades as a nurse practitioner I have worked with many wonderful physicians. As with any healthcare team, over time you develop an understanding and appreciation for each others various abilities. Fear of the unknown makes us all edgey, just like this doc. He would be far more credible if he had ever worked with an NP instead of reading the yellow pages.
A couple of corrections are in order - the physician does not have to sign my charts, she does not have to be on site but I could reach her by phone if necessary. My practice is governed by the written agreement that I have with my collaborating (new word for our doc friend) physician. We do have UPIN numbers, DEA's, hospital privileges and a key to the physician locker room. We are collaborators with MDs not competitors.
As for being called Doctor - I never let that go by, I always let my patients know I am a nurse practitioner; they seem to like that better anyway.

Posted by Susan Kraus
March 6, 2008 8:25 PM

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