Emergency Physician/Army Vet/Patient-Physician Advocate/Opinionated Citizen/Hippie chick/MUA; opinions expressed are mine and mine alone, thank you very much.
This message could not be more on point. Devaluation of education should never, ever be acceptable. Because there would no longer be pursuit of excellence, only pursuit of mediocrity.
Just wanted to give a shout out to these med students who stepped up to the plate when there were no physicians on board. Kudos to our future physicians!!
@NRA
Hey NRA, in case you forgot, for us emergency medicine military physicians, GSW's are not only in our lane, it's our highways, byways and airways...always. Think before you speak fools. Happy Veteran's Day.
@allisonoconn
Maybe because it isn't horrifying. It's humbling. And necessary. Our class prayed over those who donated their bodies and thanked them for allowing us to learn.
People, it is imperative to understand that this is not ok. This is not "modernization", this is some 5th world kind of s**t. I want the public to understand that this is not how medicine/surgery works. Some 100+ years ago standardized medical training became a necessity because
@DailyMail
@GallaherCaren
That's all? After 36 years in a public service job serving under 6 presidents? Health insurance executives who don't do jack for this country make obscene amounts no one says a word.
@dermatoIogy
Oh man...the Black cafeteria workers took care of me when I was in residency. Made sure I had food to eat before they closed. They were so proud.
Dear Student Doctors and Unmatched grads, DO NOT allow yourselves to be used as free labor by any medical institution or facility. You are not indentured servants who are required to put your lives at risk for the business of medicine. If they want you to work as
@reheisel07
@AshleyGWinter
Staff are human beings. They need rest. Doesn't help to have the public continue to have superspreader events or not heed mask-wearing as if we have an unlimited supply of health care workers.
I remain baffled as to how the PA role in the UK was permitted to move forward BEFORE scope of practice was clearly defined, BEFORE a regulation body was identified, BEFORE the education curriculum was nationally standardized and BEFORE they were licensed. Relying on trusts or
@greerplastics
I had a colleague in a similar situation. Husband initially agreed to be a househusband since she made in a day what he made in a month. Didn't help around the house or assist the kids with their homework. Didn't do jack. She lost respect. Lose respect for a man, you lose love.
Listen, I have to get this s**t off my chest. Who the f**k actually believes it is acceptable to allow a so-called "health profession" to have access to patients, to do whatever the f**k they want, yet have no regulations or guidelines(so the public is not protected),
Colleagues in the UK, as you fight this ridiculous scope creep battle, I would like to offer a few caveats/quotes for support. Be warned that you will be gaslighted & sealioned to death. You will be asked to prove a negative(ie: that PAs don't measure up to docs). Don't fall for
I've been involved in the scope creep fiasco for a long time. I am astute at identifying bulls**t when I see it. Two very common strategies used to legitimize the illegitimate are false advertising and gaslighting. Below is false advertising. One cannot claim a UK PA is a
@DrZedZha
I hate that question on employment apps. Been practicing almost 30 years and people still want me to explain a 3 month gap that happened after I separated from the Army and came home. Took 3 months to get my f***ing license. What's the probem? Ridiculous.
I was today years old when I learned not only are UK PAs not regulated, they are not required to be licensed. They are equated with physicians & allowed to practice on human beings; however, physicians have to be licensed. What kind of f**kery is this?
This, ladies and gentlemen, is what the corporate practice of medicine is--behind the scenes. So those of you in the public who blame doctors for "rushing" you through appointments like cattle, this is why. This is a directive from a non-profit hospital. Fast food medicine.
@NewsNationNow
Every time I see her picture I feel sick to my stomach. She did nothing wrong. And not one police officer is paying the price. Status quo.
This is not good news for the residents of Watertown, WI. Watertown Regional Medical Center(courtesy of the private equity-backed, contract medical group Envision) removed all of its anesthesiologists for a 100% CRNA model. In a nutshell, they replaced physicians with nurses.
@JakeGoodmanMD
The stigma and bias exists within medicine as well. Physicians on medical boards are notorious for thinking every physician with mental illness is a threat to patients, even when they aren't. Keep speaking your truth. Most of us hear and support you.
"Modernized" medicine.
1. Inability to diagnose a very common lesion.
2. No training/education needed on GLP-1 agonists. Prescribe based on whatever pharmacy recommends.
3. WTF is an "exploratory" abdominal ultrasound? It doesn't exist. It's a fictitious term.
Sigh..I cannot stand this s**t being normalized, so much so that a FNP thinks nothing about making a post seeking a book that will help her learn on the job Hospitalist Medicine, a specialty which includes acute & critical care patients as well as patients w/ complex
A refresher on why there is a shortage of physicians... Congress sets the number of physicians that will be trained per year. The Centers for Medicare and Medicaid Services(CMS), pays for these residencies. In the '80s, the AMA , the AAMC and other medical groups
Sigh...I'm going to keep posting this s**t until something changes to stop this insanity. This is someone who thinks medicine is an algorithm. "What type or length of cough...?" THERE IS NO ALGORITHM PEOPLE!! But there is such a thing as history taking, a review of systems(ROS),
Folks, this is what a manufactured shortage looks like. This is in the UK. Look how many apps there were to become a GP, and then look at the number of posts(=residency spots in U.S.) the
@NHSEngland
funded.
@alextatem
2)told her to never speak to me in a way she would never speak to a man. To my surprise, she apologized and said I was right. Never had a problem with her again.
@FennieBee
@DGlaucomflecken
Because in the U.S., insurance companies are profit-driven entities. The goal is less expenditures and more income to increase profit. So patients pay for insurance and insurance refuses to cover care and medications. Then ask why Americans still pay into this corrupt system.
This is how academic centers and their respective departments deceive the public. Using physician interchangeably with PA is not only wrong, it's false advertising, which is illegal. Normalization of deviance.
@ColumbiaSurgery
, do better.
@pppforpatients
@TakeMedBack
@phoenixpolice
One word Chief Williams: Unhinged. You have at least one walking time bomb in your department. We all saw him attempt to grab the baby. We heard him tell her to put that infant on the ground. On the concrete. In Phoenix. On a blistering hot day. This disgraceful representative
@KK_medicine
I stand with you 100%. EM is aggressive in practice but like most docs, passive when it comes to taking stance on anything controversial. We EPs know we are going to see the bad outcomes of these decisions coming through our doors, yet we remain silent anyway. This is why these
@FightHaven
He had the right to defend himself. He did try to avoid being hit then he walked away after striking her. And foolishly she follows and attempts to assault him again. She is completely in the wrong.
I don't know who the f**k
@JanetEastham
is, but she is my new Shero!! Putting hospitals on blast for allowing non-physicians(PAs) to practice as physicians..They lied through their teeth saying this s**t wasn't happening..and got caught with their pants down around their ankles.
🔴NEW: NHS England orders hospitals to stop using physician associates to cover doctors’ shifts after
@Telegraph
investigation reveals that the practice is widespread.
UK Colleagues: The situation you have with UK PAs mirrors US NPs. So does the annoying rhetoric. So allow me to give you some pearls to counter.
-"Fiction repeated often enough becomes fact."
Example: PAs are "highly qualified". Who the f**k would know since they are unlicensed,
@KurteL10
2)garment bag and said, "He needs to stay. I'll leave you guys to talk." I knew she would handle it. I came back 15 minutes later and asked for the verdict. Without looking up she said, "He will be staying." He stared at me with hatred, but no argument. Wives. The best.👍🏾
@Cleavon_MD
I'm very irritated by the fact that the "reckless ones" assume that there are an unlimited number of HCWs ready and waiting for more patients. No regard that many are burning out and walking away as we speak. They're saturated. Seeing videos like this...so selfish.
I just cannot believe this s**t is happening in the UK. It's a horrible dejá vu. For the public, PAs do not attend medical school, they take med school courses. There are no 2 yr med school programs that result in master's degrees. PA school IS NOT med school on steroids. Period.
From the same individual is a myth-buster video where they insist on going to medical school.
This insistence of forcing themselves to fit into medical progression needs to end.
It has serious consequences like accidentally calling yourself a GP (protected by the Medical Act).
I cannot ignore what is happening in the UK regarding scope creep, because it mirrors what is happening in the U.S.
"All 11 GPs at Glenlyn Medical Centre received a letter on 12 December informing them of "the start of an HR process"."
This is lunacy.
Patients everywhere report difficulty in securing GP appointments.
Yet this practice deems GPs surplus to requirements in a GP service?! 🤯
The replacement of doctors, particularly GPs, is a false economy and is a danger to the public.
The practice of medicine by SoMe. People, this is not medicine. This is a travesty of medicine. How the f**k are these people promoted as "advanced"? Absolute bulls**t and a disgrace to call this s**t "education". But it's the standard today. In America.
Listen, I don't want anymore f***ing trolls coming into my threads trying to tell me who I am. I am CLEARLY stating right here, right now that I don't and never will embrace that f***ing title "provider". Why? Because it is a verbal construct of the corporate practice of medicine
I am really so sick of this s**t. NPs wanting to get the same pay as physicians w/o putting in the work. Based on a subjective opinion, by those untrained and uneducated in medicine, that they are performing the same work as physicians. It's bulls**t.
@bubbaprog
You don't demand respect...you command it. No one shamed them, they shamed themselves. There are police officers doing it better. Learn from them. No one has to tolerate police brutality. Don't expect us to.
2)the sloppy, haphazard, subjective, apprenticeship type model that existed at the time did not bode well for patients. What has been exposed in this article is the regression, not the progression of medicine. This surgical dept and/or team arbitrarily decided that this SCP,
Physician colleagues, please, please, please stop accepting positions from recruiters like the one below. This is how you keep enabling the illegal practice of medicine. In response to a perfectly legitimate question by a physician, he accuses the doc of being egotistical.
@HalstedMD
The IM doc was right. Let's not forget that the majority of DNP degrees are non-clinical online garbage. She's using that title deceive patients.
@alisadoc1
A hospital is not a law enforcement agency. I would like to know who exactly threatened her when the only ones entitled to her records were the people "caring" for her. And docs and nurses have no business threatening to call the po-po. If they did, they should be sued.
Explain why NPs and PAs, providers with master's degrees, can practice medicine w/o a medical license yet unmatched MDs/DOs with a master's degrees cannot? And they have an actual medical education. Discuss amongst yourselves....and then I will tell you my take.
Can I say how nice it is to have nurses finally speaking out about the sub-standard NP education today? I was torn apart by NPs on Twitter for speaking the truth. 4-5 years ago it was crickets from nurses. Now the smart nurses are fed up. They know it should not be so easy to
Yo, Allergists/Immunologists, the 13 years it takes you to learn your craft is apparently "easy to master" because it's the same thing "over and over" according to the NP who was a new grad when she began working in your specialty.
It just never stops. I'm a board-certified EM doc. 25 years. No way would I take a hospitalist position unless I completed a residency in Internal Medicine or Family Medicine. This a f***ing joke. No respect for the complexity of medicine or patients. Treated like guinea pigs.
Scope creep is bad in the U.S. However, the UK is really f***ed up on a whole other level. UK PAs are not licensed, regulated nor do they have accredited PA programs, yet they are promoted by health organizations/trusts as having similar training to physicians. Absurd.
Oh FFS and so it begins! I thought neurosurgery would be immune from this 💩!
Arguably the brightest and most competitive of medics compared to a 2 year degree wielding PA!
Sit the FRCS and then il accept ‘similar diagnostic and therapeutic reasoning’
@Beaumont_Dublin
2)medical or nursing assistants, they should pay you as such. Do not agree to work as RNs because you are not. RNs are a specialized discipline and trained accordingly. They are in demand and being paid their worth...finally. They deserve it. However, the powers that be don't
@meganranney
This action is to discourage people from going to the ER. The lawsuits against UnitedHealth should increase exponentially. In addition, every single patient who gets denied should file a complaint with their state insurance commissioner. Health insurance companies need to go.
2)"highly skilled & qualified expert" if they possess none of the credentials to make those claims. How can that be if they don't possess a license, the equivalent of a board certification in that specialty, have no SOP and are unregulated? It can't be. This trust is FOS.
The CRNAs cannot get over the fact that they are not actual physicians, so they make s**t up. They teach anesthesiologists to intubate..in med school. Ok. They never attended medical school, never completed a MEDICAL residency and get an online sham s**t, online, non-clinical,
3)We're the physicians-we don't have to prove s**t. We put in the grueling work & lifted those damn heavy books. We are not conflating our profession with another or lying that we can practice in another discipline in which we have not been properly trained. I know of no
Musings by Taz..The absurdity of this entire scope creep issue is NPs/PAs having the audacity to be offended that physicians don't support it. It was their leadership who decided arbitrarily, after so many years of being on a supervised team, they no longer wanted that
@choo_ek
Our way of life..and not just in the hospital. A necessary evil to let docs know we're "good" Blacks so they know we are worth saving when in reality, all Blacks are worth saving. However, institutionalized racism minimizes our value. So we are forced to prove it.
GEORGIA DOCS, this is great news! Gov. Kemp has signed a new law that prevents NPPs from using the title doctor in a clinical setting. Truth and transparency is what it is all about.
@davenewworld_2
He's right though. I wish people would understand that all HCPs are exhausted. To the bone. And fed up. Then to have a person without scientific or medical knowledge say that their uneducated opinion is just as valid is ludicrous. Don't want the vaccination, don't take it. Leave
My lovely specialty that has permitted everyone and the pet dog to practice in it. A stroke code should have been called for this patient and her care escalated to the ED physician. Nope. NP sends her a** home in a wheelchair. Worst headache of her life, hypertensive, sudden
2)it.
Caveat
#1
: "The practice of medicine is the gold standard by which all other disciplines of health provision are measured. The onus is on them to prove, with VALID evidence of sound quality and unquestionable standards and methodology, that their discipline measures up."
3)want to pay. If you work for free, they can attempt to use nurses less just to get by and save money. Don't do it. It harms you, it harms the patients and it disrespects the nurses who deserve every f***ing cent they get paid. If the facility is short-staffed, that is an
ATTENTION!! To all docs who despise prior authorizations(PAs)--there is hope. In 2007, Gary Gibson, MD sued Medco Health Solutions, a health insurance company in Ohio, for compensation for time used in performing prior authorizations. Duties which could also have been performed
Appears the NP who didn't recognize shingles(from my earlier post) was advised, by crowdsourcing, that the patient has shingles. One would think that would be enough. Nope. Now she asks how to treat. She has no idea how Acyclovir is metabolized(hint: it's not the liver) or how
The practice of medicine by SoMe. People, this is not medicine. This is a travesty of medicine. How the f**k are these people promoted as "advanced"? Absolute bulls**t and a disgrace to call this s**t "education". But it's the standard today. In America.
This is a perfect example of what can occur when people who have no business practicing medicine do so-w/o accountability. An AZ naturopath performed liposuction on a patient which led to complications. Pt sued. In AZ, statute mandates that the only expert who can testify against
Every time I see s**t like this post from "Nurse Practitioner Newbies", I'm going to magnify the absurd statement that Sophia Thomas, the former president of the AANP said about NPs upon graduation.
Out of respect for this NP's husband who put his business out in the street, I am redacting her name. She has no business treating a family member, particularly in an area in which she is untrained. It is unethical and dangerous.
Oklahoma governor doesn't want NPs prescribing controlled substances w/p physician supervision. So he vetoed a bill that would enable them to do that.👏🏾👏🏾👏🏾Some politicians get it-that's it's about safety and protection of the public. But many don't.
@Caulimovirus
This was common when I did my Peds rotation in residency. The RNs and peds residents would hold the babies while charting. I began doing the same and continued it in the Peds ER(when it was slow). The human touch. Nothing like it.
@JaniceBakerRD
@MichaelAlbertMD
One way you can assist your doc is if refused on unfounded grounds, file a complaint with your state insurance commissioner alleging that an individual who is not your doctor and doesn't know you(ie: medical director of said insurance company)is obstructing your care. Get the
This is my last post for the night. Sometimes this s**t is just too much. This is a letter from the Chief Physician Executive at Atrium Health in NC, supporting the unsupervised practice of NPs. He regurgitates the same reasons as legislators. Here's the problem, he makes a
I'm coining a new term. "Popcorn" medicine. Exclusive to NPs. When a NP "specialist" posts a patient's presenting complaint then asks for a diagnosis. This is why "advanced" nursing ≠ medicine. The main difference? Cognitivism. Yeah, it's why medical education takes years.
What a move by the RCP. Totally antithetical to their core mission. Sellouts. PAs have been in the UK since 2005. Unregulated. Suddenly, regulation and prescribing rights are of the utmost importance. Let me say that as an EM doc, I have to be very familiar with pharmacology so
By now, most of us have seen the now deleted tweet from Glenfield Cardiology that caused a ruckus. I want to use the attention gained from this incident as an opportunity to gently remind all physician colleagues of the decades-long scope creep battle PC docs(IM/FM/Peds/Psych)
I want everyone to see the face of a fierce patient advocate. He is Richard B. Zelman, MD, FACC, a long-time interventional cardiologist at Cape Cod Hospital in MA. He is also a former medical director of their Heart and Vascular center.
@LondonDocDave
@jmugele
I understand that your comment was made to detract and distract. So allow me to put us back on track. Let us thank Dr. Mugele for what he has selflessly contributed to our society, including his children. Thank you Dr. Mugele. We see you.
6)The importance of education is also why I have this quote in my bio:
Caveat
#3
: "Devaluation of education should never, ever be acceptable. Because there would no longer be pursuit of excellence, only pursuit of mediocrity."
I want every physician in MedTwitter to pay attention to this s**t. From the American Academy of Physician Assistants(AAPA): "A PA’s education does not end at graduation. The PA profession is the only medical profession that requires a practitioner to periodically take and pass a
@mahad_minhas
2)affirmative action came to be. Because people just won't do the right f***ing thing. Black physicians represent 3-5 of all docs in medicine and it hasn't changed for decades. There is a reason why--and it isn't because we aren't qualified.
4)administrative issue--it not your cross to bear. They knew this surge was coming and did not prepare, expecting HCWs to volunteer once again. That did not happen because people have bills to pay and have to put food on the table. Do not allow them to convince you that you need
Welp, EM docs, it's happening...With CMGs opening their own EM residencies, the proliferation of NPP "residencies" and "fellowships" and ignoring the warning by the American Academy of Emergency Physicians(AAEM) in 2016 about the threat of an oversupply of EPs, we finally did it.
This is what bulls**t looks like. Lip service to appear important-but no receipts so the public can understand. Contrary to popular belief, PA school is not med school on steroids. Allow me to interpret the BS. If one is REQUIRED to apply to a med school, there is no "IF".
@MsBabyCatcher
I failed part I of my EM boards then got deployed. Had to delay re-taking it for a year. 2nd time passed. 2 decades later, no one cares. You will pass next time. Grieve, but keep it in context. It is just a test. It does not define you.
3)For the record, false advertising is illegal in the UK. The statement circled in red is false and deceptive. The important info that is left out is that UK PAs are neither licensed nor regulated, so they cannot possibly be experts. In anything.
@mahad_minhas
I took note. And this is why a true meritocracy never existed in this system and never will. When left to human beings representing the majority of one race/ethnicity to decide who is in and who is out, one cannot rely on objectivity or meritocracy. This is exactly why
VIRGINIA PHYSICIANS!!! The s**t just gets worse. There is a proposed bill(by a NP no less) that permits NPs to practice unsupervised after 2 years while mandating MD/DO to complete 3 years of residency BEFORE they can get a license to practice. Right now they can practice after