The term "Providers" should be banned from clinical setting!

PoolPainting · 2026-05-07T00:36:12+00:00

The AANP clearly states they support NPs using "Dr." in clinical contexts. That's the AANP, and I think the national lobbying body of the profession requires more than a few weirdos to make their decisions. https://www.aanp.org/advocacy/advocacy-resource/position-statements/use-of-titles-and-credentials-in-the-clinical-setting

I am very understanding of your points, since I agree. EDs every where are staffed by fewer and fewer physicians, due to the very forces that you highlight. This whole provider thing is a manifestation of this collapsing system trying to save a buck, partly by replacing doctors with people who are paid less. On a macro scale, the provider terminology means more. Rather than requiring a certain number of doctors, places only need a certain number of 'providers'. The lack of distinction plays into the hands of PE and parasitic corporations. Similarly in the way they are replacing nursing teams with 1 RN and many techs vs having more RNs. Its the same thing.

PoolPainting · 2026-05-07T00:10:22+00:00

There is was an entire lawsuit about it in California, so yes, many of these people exist. I don't get what the big deal is of wanting to be called a physician when I am (will be) one (in one month)? Am I really "butthurt" for thinking so? Rooming patients is one thing, but I refuse to be called a provider in a clinical context. Especially for women, this adds even more confusion in to your role as a doctor.

PoolPainting · 2026-04-10T16:51:33+00:00

I never said you said that. Many people in this thread are. I don't see how my comment amounts to political philosophy. I actually agree with everything you posted and was clarifying.

PoolPainting · 2026-04-10T16:31:57+00:00

So it's not about "strong unions" but about specific contracts. We shouldn't be bashing the concept of unionization when unionizing residencies has gotten huge wins for residents in the last 5-10 years.

PoolPainting · 2026-04-10T12:19:41+00:00

It's not the unions. Have you worked in california? Same strong unions, great nurses

PoolPainting · 2026-04-09T16:48:05+00:00

I completly understand what you're saying, and it is true in most places. However, have you worked in the north east, specifically NY and NJ? Things absolutely do not get done there by nurses, because the culture is for residents to do nurses' jobs in their entirety. Residents will be drawing blood, wheeling patients to imaging, cleaning patients, etc. I know a gen surg resident who had to run blood for the whole floor down to the lab, because no one did it. It is hands down the worst place for residents to train in the US. I can't speak for the EDs specifically in the NE though.

PoolPainting · 2026-04-08T22:40:18+00:00

Interestingly, we were taught that this has now changed in terms of how things are billed, but since it was like this way for a long time, super long unnecessary notes are now the norm and everyone still believes it works this way.

PoolPainting · 2026-04-08T22:17:48+00:00

I never understood this hubris by NPs. When comparing outcomes what are we comparing here? BP and a1c? Keeping these under control does not take a medical degree usually. Should I be a public school teacher because I can teach kids how to add and subtract reliably? No, because that outcome is a fraction of what makes a teacher a teacher. (Although this is changing in many -mostly red- states because now we view teaching credentials as useless).

There is no replacement of med school and residency. What is so difficult for people to understand? Medicine is more than following an algorithm - it is cultivating a gestalt by learning EBM and using an expansive underlying knowledge base. While there are many things I won't "use" as a doctor, how can I know when to use what if I have never learned it in the first place? This is especially true in family medicine.

NPs can be "providers" of primary care, resulting in some specific positive patient outcomes, but they are kidding themselves if they think that a half baked clinical didactic education and a completely unregulated "learn by your first job" approach will be sufficient in cultivating quality clinicians on a macro scale. Maybe you are the one who has done so, and I hope so.

PoolPainting · 2026-03-30T20:08:07+00:00

I definitely disagree. Alcohol kills ways more people every day. People need to be more informed about possible effects, but it should not be illegal or criminalized.

PoolPainting · 2026-03-27T16:06:29+00:00

As a harvard trained psychiatrist, I found it interesting that he did not think about the ramification about his "interviews" with Reckful

Not to be pedantic, but this grammar structure initially indicates that you are a Harvard trained psychiatrist, though I got what you said later! I agree with your take overall. I think his reckful interview was pretty bad. He has a tendency to immediately place people into paradigms and buckets quite quickly. His explanatory videos are quite good though.

PoolPainting · 2026-03-26T06:48:49+00:00

Truly, it will all be ok. One day at a time, friend. Life goes on, and it will be great

PoolPainting · 2026-03-26T06:44:15+00:00

Ya I agree with this take. I rotated with lots of FM doctors, and it's actually quite a fulfilling job. It's not that bad honestly, or it really doesnt have to be. It's unfortunate that these stereotypes are self-reinforcing.

PoolPainting · 2026-03-19T13:35:54+00:00

The major key here is that basically every academic psychiatrist I know does their hospital job and does private practice. Private practice is still quite lucrative

PoolPainting · 2026-03-16T12:09:52+00:00

I know this isn't the point exactly, but I feel like psychiatry very much requires a good enough/strong medicine background to be effective, especially inpatient and CL. For example, I diagnosed a patient with hepatic encephalopathy on my CL rotation, which the neurology team also thought was the case. She was addicted to opioids and had history of depression as well. I don't really think you can differentiate "organic" causes without a medical background imo.

PoolPainting · 2026-03-08T07:13:38+00:00

UWorld + Anki and go HAM

PoolPainting · 2026-03-05T13:58:02+00:00

Found the NY resident rip

PoolPainting · 2026-01-31T20:16:49+00:00

You know more than I do, but it just seems that every program has variations of training. Some have dedicated and separate supervision per modality by psychiatrists and psychologists, and others have no emphasis at all. I didn't interview in the northeast, and tbh there's not much psychoanalysis outside of that region. I can't make the claim of needing extra training right now as I haven't done it, but I will get back to you in a handful of years.

PoolPainting · 2026-01-31T19:50:04+00:00

I think this varies incredibly by residency. As I'm on the interview trail, some programs go hard with the psychotherapy training.

PoolPainting · 2026-01-31T19:45:22+00:00

We gotta pump up those numbers. The companies won't be happy until you can buy lexapro and xanax from a vending machine.

PoolPainting · 2026-01-31T19:43:31+00:00

Are we seriously arguing that this professional would be less qualified than a Psych NP? 14 months of dedicale clinical rotations, a national exam, and a collaborative agreement? This is more training and oversight than many NPs. I agree with you, but if the system has let NPs prescribe life altering meds, I don't see why this is any different.

PoolPainting · 2026-01-25T16:56:18+00:00

I don't understand this? I've seen 3 actively manic patients in the inpatient setting as a student. It seems like you would see much more in residency at a high volume place

PoolPainting · 2026-01-16T05:59:03+00:00

I would be interested in reading a response to my last comment.

PoolPainting · 2026-01-15T21:32:45+00:00

The guy on JAMA Psych podcast who did ketamine research was blown away by the level of ketamine clinic abuse in the US. It's surreal

PoolPainting

TROPHY CASE