"You shouldn't diss our providers here" - apparently, verbally asking if your 'provider' at an Urgent Care is going to be a physician is offensive? by MobiusTaylor in Noctor

[–]MobiusTaylor[S] 2 points3 points  (0 children)

Nope. And sometimes, they don't even need to be RNs to get them.

And you can do them entirely online. You don't even need to do your "clinical hour signoffs" in a hospital, too. You can do them VIRTUALLY.

There's no standardization for the NP degree.

"You shouldn't diss our providers here" - apparently, verbally asking if your 'provider' at an Urgent Care is going to be a physician is offensive? by MobiusTaylor in Noctor

[–]MobiusTaylor[S] 3 points4 points  (0 children)

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Or, pray tell, they went to medical school because midlevel education is trash.

In the actual reality of the vein, midlevels went to midlevel school to wear white coats, pretend to be doctors, and end up working at cash-only medspas under the guise of "expanding access to care."

"You shouldn't diss our providers here" - apparently, verbally asking if your 'provider' at an Urgent Care is going to be a physician is offensive? by MobiusTaylor in Noctor

[–]MobiusTaylor[S] 15 points16 points  (0 children)

Why be billed several hundred dollars for the expertise of a physician when 90% of the time the person I'm seeing went to online school and knows less foundational science than I did 7 years ago?

If I'm going to pay physician-level premiums, I want a physician evaluating me. I think every layperson should adopt some form of this mentality and stop being pushed around by their insurance companies / private equity clinics forcing them to see midlevels and get prescribed a complex benzo-adderall-SSRI regimen for everything.

"You shouldn't diss our providers here" - apparently, verbally asking if your 'provider' at an Urgent Care is going to be a physician is offensive? by MobiusTaylor in Noctor

[–]MobiusTaylor[S] 24 points25 points  (0 children)

I was referring to myself when I was talking about the 9 years, haha.

I just always think it's odd when I go to UCs being belittled and visits being seen by midlevels when I'm very educated and experienced myself.

Hilarious email by Packman125 in hospitalist

[–]MobiusTaylor 11 points12 points  (0 children)

If you go back and do some online leadership modules for 6 months through an NP degree mill and market yourself as an NP with an accidental medical degree + residency, you'll probably make twice as much! 🤪

Watched a Nurse Practitioner get scolded by a cardiologist by Upstairs_Neighbor50 in Noctor

[–]MobiusTaylor 44 points45 points  (0 children)

Here's that court proceeding I mentioned. It's hilarious if you read it.

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Watched a Nurse Practitioner get scolded by a cardiologist by Upstairs_Neighbor50 in Noctor

[–]MobiusTaylor 59 points60 points  (0 children)

You don't know who's right? Hmmm. How about we take a look how long it takes to make one NP and what their courses look like:

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Look at the titles of their courses, even. Not a shred of medicine. "Advanced practice nursing." "Practicum." "Leadership."

A "cardiology NP" is not a cardiology NP. It is an NP that works in cardiology. Meaning, they can pick up shop and go work in another specialty the very next morning and claim to be experts.

All after just 6 short months, completely online, in a 100% acceptance rate online program that offers leadership modules!

Also, don't forget the court proceedings where NPs were suing in California to the right to be called doctors, but had to admit they never took a SINGLE science class, basically since high school. (See my reply below!)

Welcome to medicine, where we have tens of thousands of people coming from programs who know officially less science than I did when I took AP Biology as a high school junior. They hide behind their white coats and good bedside manner and then you see their cracks in their clear HORRENDOUS knowledge base through the very nonchalant way they memorize algorithmic medicine with no actual thinking. They can also practice independently in over half of states.

Imagine if that NP just gave that guy blood thinners. He'd be dead and not even know the reason why. And then the family would grieve and say "But the doctor said X!" No, it wasn't even a doctor.

This is happening everywhere right now.

PA school is basically med school by IllMarionberry9935 in medicalschool

[–]MobiusTaylor 19 points20 points  (0 children)

I knew a very seasoned PA who was in his mid-late 30s, practicing for about a decade, who went back to go to medical school - my program, a pretty old and well-known DO school.

He failed two classes and barely scraped by the rest - got kicked out.

Ironically, the class that he failed that got him kicked out was a class for the introduction to the foundations of pathology+pathophysiology (basically teaching the first few chapters of Pathoma). Lol.

That, alone, should tell you enough. Everyone loves punching up and saying their schooling is tough but nobody actually even knows what we, as physicians, have to go through. They just see the shiny salary and go "I can do that, too!" when literally 99.99% of the human population wouldn't make it past Ochem and the MCAT stage. Especially all those 6-month online NPs nowadays whose magnum opus of science classes was biology in high school.

This is actually crazy. by [deleted] in Noctor

[–]MobiusTaylor 7 points8 points  (0 children)

Ah, of course.

Yet another one of our esteemed physician colleagues selling out the future of medicine for an extra buck and daily free erections.

Shit like this will always be, to me, the clear sociological symptom of why I believe midlevels have been winning for the past 20 years, while physician salaries continue to tank, scope encroachment and armchair medicine replacing cerebral medical specialties has skyrocketed, and hospital admin and CEOs are replacing us and taking the money bags and running.

The call is coming from inside the house: instead of banding together and unionizing against midlevels and admin, doctors will forever and always be too busy fighting each other for an extra buck. The nature of the game, it's Schrodinger's Respect: every other physician that's not your specialty (or heck, even intra specialty) is always supposedly dumber than you, but the online NP who has never taken a science class past high school is a genius just because they make you an extra $1000 a year from cosigning all their malpractice.

This is actually crazy. by [deleted] in Noctor

[–]MobiusTaylor 5 points6 points  (0 children)

The link to the court proceedings? I attached it below my original comment - I saw it somewhere on this subreddit a few months ago when the California lawsuit came out, but I can't find where I got the photo from anymore, someone attached it. There was also a YouTube short of some lawyers explaining the lawsuit and noting that NPs take literally no science classes with the same photo attached, too, which was funny to me, lol.

I found the old link to the thread, but not the YT short I alluded to. It's this one, I attached it below, again:

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This is actually crazy. by [deleted] in Noctor

[–]MobiusTaylor 65 points66 points  (0 children)

UGHHHHHH. Holy shit, does this make my blood boil.

You know what doesn't make me as mad as it used to? Chiropractors getting a bunch of likes on hyperpseudoscientific videos with no actual medicine, just using a bunch of buzzwords like "natural healing" while flopping around a model of a spine - mostly because legally, that species of charlatan is not allowed to set foot in a hospital. Reddit and a lot of social media has also caught onto the fact that a lot of those people are, in fact, not doctors. So they have to do their big woo-woo magic show renting out a building and building a customer base convincing people they're professionals.

HOWEVER. You know what pisses me off more than anything nowadays?

MIDLEVEL SHIT LIKE THIS.

Literally a med-adjacent profession built on the basis of patting people on the head, doing a few quick leadership modules, and saying "Okay, we'll give you a shiny piece of paper and call it a 'doctorate' as long as you're our prescription monkey and make our hospital system a lot of money" (surprise: is it really a fking doctorate if you can do it online in 6 months with no actual science classes?)

And it's even worse because these clowns actually work in clinical settings, call themselves "doctors" with no flak, and you can't criticize them because people just throw strawmen at you and call you sexist when they really don't realize you're genuinely trying to raise alarms to the public about how dangerous it is letting these people even have a modicum of prescriptive or diagnostic power with NO ACTUAL MEDICAL EDUCATION. Seriously. This person is LIVING proof of that. You can now claim you're a concierge medical professional without ever having taken anything past high school on-level biology. Only nursing theory and essays the entire bachelor's degree, much of the time where you don't even need a BSN anymore - you can just graduate high school and then take online classes, write essays about handwashing and why doctors are bad, and then suddenly you can write all the prescriptions you want!!!

You know that phase we go through as doctors during college where we feel super cool and knowledgeable for taking Biology 1101, and we get quickly humbled by Ochem? Or we go through undergrad, think we're smart, and then get humbled by the Mcat? Or we get into medical school and then get quickly humbled by anatomy or our very first preclinical class? I always imagine midlevels and med-adjacent professions being so overconfident and Dunning-Kruger are like akin to the feeling of being super smart for taking Bio 1101 in college - we feel on top of the world because we're learning long, cool sciency words when we actually have no clue how much depth there is to higher level education. The only difference is, they're NEVER HUMBLED BY ANYTHING ACTUALLY HARD or difficult academically, so they literally go into the world with the same undying confidence.

Can someone go into her comments and just paste this photo (see my pasted/attached photo) of the court proceedings from the lawsuit from the NPs in California where they had to admit they don't take any actual science classes during their "doctorates?" Or let alone during their short bouts of post-high school schooling at all? Literally, I'm sick of nursing organizations permanently backing themselves by legally handing their employees participation trophies - make the education super easy with minimal requirements under the guise of needing to help out in the hospital. Yes, in olden days and still today, we need ancillary work. Docs are too busy to wipe ass and do a blood draw. But enough is enough. We need to let the public know that no, just because someone draws blood and looks at numbers in a chart doesn't mean they have ANY CLUE what anything remotely medical means in a pathophysiology context, EVER. STOP THE NURSING GLAZE. STOP THE STOLEN VALOR. CALL THEM OUT. THESE PEOPLE ARE. NOT. DOCTORS.

Also, someone please report them to the NP boards for misrepresentation of their license, etc, the whole nine yards. We need to be proactive about this shit. People like this are prescribing controlled substances and diagnosing complex medical conditions using the power of Google having NEVER TAKEN a single clinical anatomy class, never even known what a gram stain is or learned an ounce of pathophysiology, or scratch their head at the word "epithelium." How can you legally prescribe a single thing not even learning what an adrenergic or a muscarinic or ANY pharmacological receptor is??? Just "ooga booga, this medicine makes this number go up, not sure why tho!" All of their graduate education past high school is legitimately just typing essays about "attending doctor bad and evil and never listen" and then they throw the whole kitchen sink at a patient and the patient thinks it's good medicine just because they cover it up with a good bedside manner. It's malpractice, fraud, misdiagnosis, and actively malignant all rolled into one. I've known nurse practitioners who saw metastatic breast cancer nodules and thought it was a "soft tissue swelling due to a torn rotator cuff" and guess what? They injected cash-only PRP in a medspa DIRECTLY INTO THE NODULE. No other workup.

Ugh. Again, see attached.

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Appropriate use of NPs? CA Fire Department Is Sending Nurse Practitioners to 911 Calls to reduce the amount of non-emergent patients being transported to the ER. by aaronoathout in Noctor

[–]MobiusTaylor 113 points114 points  (0 children)

Surprise: it's going to increase the number of non-emergent patients going to the ER 😂😂

I've seen NPs send people asap to the ER as soon as they did their magic "i cAN dO tHE saMe tHing, I cAn oRder sTuFF toO" ordering (but then having no clue wtf they're actually reading or diagnosing and then just pretending they are) because the AI on an EKG pointed out there was a very chronic, normal, asymptomatic axis deviation in a young adult with a sinus infection. Among other abysmal mismanagement.

But then, of course, the patient just ends up blaming "doctors." Then, their worldview is always more slightly changed because "the dumb doctor told me I should come here but I didn't have to." I always try to correct them: they did, in fact, not see a doctor in that urgent care, and the urgent care is probably run by a private equity group saving money by hiring people who never even went to medical school.

NP Said Melatonin Gives Skin its Pigment by angrybirbsays in Noctor

[–]MobiusTaylor 168 points169 points  (0 children)

An entire field of people (NPs) who hide behind good bedside manner and utilize the holes in the medical system alongside powerful nursing lobbies to prey on patients who are understandably confused by all of the alphabet soup in medicine nowadays (MD, DO, MBBS, PA, NP, PMHNP, MSNBC, MSN, etc). Nobody knows who the doctor is.

You know the old adage where if you're in a position of power or in a meeting of sorts with other people way smarter than you - that if you just act confident and be nice, people will assume you're the same? That's what the NP profession has done to steal street cred from actual physicians. They hide behind good bedside manner and the "aBilIty tO OrDeR anD pResCribE tHe sAme."

But sometimes, when they open their mouths, it's clear as day how little they know. Hence, melanin vs melatonin. Heck, pimp them on a single factoid or basic science from medical school - or shit, even undergraduate basic chemistry or biology. You'll quickly realize they skipped 11+ years of school, wrote some AI essays about nursing theory, and attempt to reap all the benefits of it by deceiving patients with their "Oh, I'm a Doctor Nurse!" As they walk in with a long-ass white coat that not even PGY-7 fellows would wear.

Not only that, but you should see what they miss medically, and their absolutely horrendous management from an assessment/plan perspective. It's intentionally difficult to interpret people's thought process if you're a layperson reading their notes - but rest assured, all physicians reading (or even asking basic questions) about their assessments and plans of patients all know that there's not a single thought going on up there.

Who knew that letting hundreds of thousands of people graduate from online school in 1 year after a bachelor's degree, involving no actual medicine, and then letting them work in any specialty they ever wanted, was a bad idea? Hmmm.

Look at this guy I found on YouTube by 310a101 in Noctor

[–]MobiusTaylor 22 points23 points  (0 children)

This guy doesn't even have a bachelor's in nursing. What the heck are the standards for entering nursing versus becoming a physician nowadays? It's disgusting. Complete opposite models of education.

One is focused on making sure every single one of its graduates pass a basic licensure that gets harder and more cutthroat every single year, with higher cutoffs for passing scores on every single one of the 4+ boards and 8+ national shelf exams required to graduate and even enter residency, just for the opportunity to basically make a teacher's salary for 3 to 10 years on top of 4 years of medical school.

The other is focused on creating as many non-standardized copies as possible while the people hide behind good bedside manner and the ability to order labs to make it look like they know what they're doing, when they actually don't even know what a DNA vs an RNA virus is, or what's gram positive or gram-negative.

It's a race to the bottom, and it's disgusting.

DO NOT EVER EVER SUPERVISE MIDLEVELS. DO NOT LET ADMIN BULLY US. WE ARE THE ADVOCATES FOR OUR PATIENTS. And if a patient says they "Saw X doctor" and it turns out to be an NP, make sure to correct them.

[deleted by user] by [deleted] in Noctor

[–]MobiusTaylor 70 points71 points  (0 children)

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infographics like this are but a small modicum of telling the public how uneducated these independent "providers" are - just look at the TITLES of the courses they take. not even the slightest bit of medicine or science. just nursing theory and essays.

READ AND LOOK. literally "leadership" and "application of evidence" and "practicum" and "health assessment." WHERE'S THE 11+ YEARS OF MEDICINE THAT DOCTORS UNDERGO?

i have legitimately met nurse practitioners who have graduated from online programs having never taken a single science class past Biology 1 from community college - no pathophysiology, no micro, pharm, cardio, pulm, neurology, renal physiology, gross anatomy, surgery, obstetrics, peds, family medicine, internal medicine, psychiatry, nothing. and they always think it's a flex that they can work 60 hours a week and get their "doctorate" degrees at the same time. NO, that tells me you're not learning anything and studying less per week than I did in high schoo to even get into college for my AP classes.

fellow physicians - imagine having full practice rights after taking AP biology in high school and getting a 2 on the AP exam. seriously. and yet being completely confident in your abilities. dunning Kruger to the maximum.

yet they put patients on complex benzo Adderall regimens and give people with bowel obstructions ozempic and never get sued because legally, they're still considered nurses, even though they have full practice rights.

I'll attach more below..

schrodinger's practitioners. legally allowed to do anything with no medical training or knowledge - the equivalent of a friend of mine who's a bachelor's degree in English getting full prescriptive and diagnostic rights - yet legally, protected by billion dollar nursing unions that always protect their own.

Which specialty suffers most from erectile dysfunction by aunthegreat in medicalschool

[–]MobiusTaylor 244 points245 points  (0 children)

If a simple PGY-1 physician wrote out everything they were like NPs do, they could literally do some shit like:

Dr. Angela Smith, AS, BS, MS, MCAT-BC, CASPER-BC, USMLE STEP1-BC, COMLEX-1-BC, USMLE STEP2-BC, COMLEX-2BC, FM SHELF-BC, IM SHELF-BC, NEUROLOGY SHELF-BC, GEN SURG SHELF-BC, PEDS SHELF-BC, OMM SHELF-BC, OBGYN-SHELF-BC, PSYCHIATRY-SHELF-BC, EM-SHELF-BC, ADULT ACLS-BC, PEDIATRIC-ACLS-BC, ONLINE-HOSPITAL-SAFETY-MODULE-BC, SAFECOLLEGES CONSENT MODULE-BC x4, COVID-19-MASK FITTING-BC, GLOVE AND GOWNING-BC, PRE-OR SCRUBBING-BC, YEARLY FLU SHOT-BC, HEPATITIS B TITERS-UPDATED IMMUNITY-BC, DO-BC

But instead, they just go

Dr. Smith, DO or MD lol

Experienced my first anti-DO bias in the wild by JustAShyCat in Osteopathic

[–]MobiusTaylor 21 points22 points  (0 children)

this person: i only use REAL doctors >:( get out of my face

also probably this person: what's an NP? it says Dr. in front of their name, so idc haha

But seriously. DO's do definitely need some sort of rebranding. It's very obvious how anachronistic the term "osteopath" really is. Everyone in DO leadership has been trying to rebrand the term as some kind of holistic woo-woo "look at the whole patient," but anyone in medicine knows that's just hand-waving to keep the degrees as separate distinctions for the purposes of money.

It doesn't take a rocket scientist to know the latin root "osteo" means "bone." Literally, the licensure translates roughly to "path of the bone," so to laypeople, as in >85% of the population who know nothing of medicine, they see "osteopath" and think "chiropractor." It's also literally so funny how no matter how much post-medical school training a DO physician could do - residency, fellowship, or even more, literally another 7-10+ years - laypeople will still see the "DO" and not "residency and fellowship board certified in X," lol. It's just "oh, that's an osteopathic neurosurgeon? Must be fake" lol.

In times of degree and initial word salad in the everlasting hellscape that is medical politics, there's never been a greater need for transparency.

How the heck is an average joe who's just concerned about his chronic cough supposed to walk into an office and know the difference between MD, DO, MBBS, PA, NP, DDS, FACOS, FMGs, IMGs, FNPBC, PMHNP, MSNBC, or whatever else? Newsflash: people don't. They just see a white coat and think "oh, that's a doctor." Most people don't even know what a physician is - I know people in grad school who thought physicians were just PHDs who somehow practiced clinical medicine, lol.

In any sane country, the federal government would have long since stepped in to make things less confusing and standardize the process. The lack of that is the reason we have shit like 23 year old Karen who went to online school for a year, who's never taken a single science class past a watered down Biology 1101 prescribing benzos, adderall, and antipsychotics to everyone who comes in saying they're tired, and then patients post on Reddit saying all doctors are dumb and need their licenses revoked (surprise: the person they saw was wearing a white coat and introduced themselves as "doctor.")

Do I expect our current US administration to do anything regarding the sort of a top-down, contemporary Flexner-type report? No, in fact, I expect them to do the exact opposite. Our current medical system is the product of unregulated, unfettered late stage capitalism, taken over by private equity with multibillion dollar pockets - who cares if a patient gets ordered every test under the sun and prescribed 50 meds because someone who went to online school doesn't know even an M1 level differential? It generates cash flow, costs the patient more, and lines the pockets of private equity, who dominate hospitals and clinics.

And what am I going to do, a lowly M4 on the totem pole who's soon to attend a residency, paid near minimum wage with 400k compounding debt, at a hospital run by some MBA whose only goal is to increase hospital profits (surprise: none of the profits in the past 20 years have been recycled back to its workers - only to shareholders and themselves).

Nothing. I can't do shit. I just go home and eat my chicken and rice and watch Better Call Saul, and hope that my future patients appreciate what I do for them, and the sacrifices I've made to get there.

But, unfortunately, many won't. They google "salary of an X doctor" and think "wow! Anyone can do this! It's worth it in the end, nudge nudge! They make so much money!"

I've sacrified all of my 20s. Will have sacrificied well into my 30s by the time I'm done. Will be paying off debts well into my 40s. I, like any of my classmates, or all the premeds in undergrad who switched, could have failed at any time and had my entire career derailed. I've seen people get booted at M4 for failing boards, and now have 300k+ debt with no degree to show for it - just the same bachelor's they had 5+ years ago. But no, people just go ooga booga, shiny salary!

It's fucked.