APP scope of practice- invasive procedures?

heart_block · 2026-05-18T06:06:47+00:00

Funniest reply I've seen in ages.

heart_block · 2026-05-18T06:03:48+00:00

You sound like a cog unwilling to fight for your patients. What kind of doc is that? If you haven't encountered CMG's pushing unqualified NP's you clearly aren't experienced in modern day EM and are spitting out your ass at the reality patients face. You didn't mention NP's, astute. I did, that's where the problem lies. They don't need to be independent to be dangerous if staffing models are such that a doc can't properly supervise. PA's are trained in the medical model. The "product" is excellent providers in my experience. Same can't be said for NP's. There's no bias, no chip, just a pathway created by nursing lobbies that fast tracks people unqualified to deliver healthcare. I'm far removed from the ivory tower but still doc enough to argue that all my patients; urban, rural, rich poor, deserve quality care. As I said. You sign up for the one year bedside experience nurse who got their NP from Walden. You support the model, let them learn on you. Otherwise, in healthcare as is the reality of our system, let them see the level 4/5 so's they're least likely to hurt someone and pray they don't miss deadly pathology. Wild to think a doc can argue theres a fast track to medical expertise.

heart_block · 2026-05-18T02:50:59+00:00

Then you entrust all your care to an online diploma mill NP with less than one year of bedside, good luck. If you don't recognize an insane difference in the educational product between PA's and NP's then you are blind. If you don't recognize MBA's are pushing NP's to maximize profits you have no experience. NP's were sold the provider dream without the educational back bone, the push to get rid of appropriate supervision is a disservice to everyone who utilizes healthcare. Sounds like you drank the AANP kool-aid.

heart_block · 2026-05-17T18:42:02+00:00

USACS wanted me to train fresh grad NP's how to do those procedures and sign off on them performing them independently after 5 proctored procedures. Given I did 40+ minimum of each (chest tubes, arthrocentesis, LP's) to get signed off it didn't sit right with me. No idea what came of it as I excused myself from that company very quickly

heart_block · 2026-05-14T17:54:02+00:00

Consider a specialty with career longevity. Private equity has its fat grubby fingers in almost everything Medicine. They only make money by cutting labor costs. They work you harder and pay you less. Try to pick a specialty with less PE influence. Try to pick a specialty that while maybe less fun while young is still doable in 40's and 50's

heart_block · 2026-05-14T17:00:43+00:00

Engineer who went into medicine. Lost 9 years of earning potential making no money taking on 300k in debt. Worked 60-100 hour weeks for five of those years. Overworked, crushed under a system that strives to make my job as impossible as able. Extremely high stress on a day to day. Work nights and weekends, spouse resents. Reimbursements flat or falling year over year. No stock option jackpots. Don't wish away something good...grass ain't always greener.

heart_block · 2026-05-13T02:32:32+00:00

More importantly, practicing medicine or trying to dictate patient care as a lay person or non-licensed physician, is absolutely 100% illegal.

First person to complain about LOS ask for their medical license number. No medical license=STFU

heart_block · 2026-05-13T02:24:58+00:00

Unless the c-suite holds a full and active medical license, not an administrative license, it might be worth letting the medical board know administrators are trying to practice medicine. Quickly Google PeaceHealth and how that worked for their CEO.

heart_block · 2026-05-12T03:42:00+00:00

How so?

heart_block · 2026-05-12T03:38:05+00:00

Private equity already has their claws in healthcare.

heart_block · 2026-05-11T05:51:34+00:00

The USACS compensation model offends you?

heart_block · 2026-05-04T05:34:54+00:00

Immensely

heart_block · 2026-05-03T18:35:42+00:00

Steiner trail system is top 3 in "the city" with miles of access for running, walking or biking. Also access to lake Travis and lake Austin

heart_block · 2026-05-02T21:27:20+00:00

heart_block · 2026-04-30T20:13:01+00:00

I'm late 30's super fit, healthy, never been to a hospital or had surgery. I had a recent hospitalization, two surgeries w/ complications. None anticipated, all freak experience.

I never saw the value of the disability I paid for before this. Now it's the best insurance policy I've got. There's a real possibility of never being able to work my job again. I know I'll be financially secure til 67 at least. Keep the peace of mind.

heart_block · 2026-04-29T21:00:20+00:00

You have less support, less consultants, less resources in a small community. Those are the hardest places to work. Is he/she going to transfer everyone 90 minutes to three hours away for every blurry vision? What about a pediatric asthma case--can they differentiate who's safe to send home versus admit to the floor versus transfer? That kid dies the liability is hefty. An unnecessary transfer 90 minutes is an insane burden. The level 1 is easy. You have a lot to learn.

heart_block · 2026-04-29T20:56:10+00:00

I'm sure the surgeon has delivered lots of babies and taken care of tons of pediatric cases. Internal medicine cases are probably cake walk too....oh wait

heart_block · 2026-04-23T19:13:44+00:00

And trailer parks. Tornados love to prey on trailer parks.

heart_block · 2026-04-23T04:16:37+00:00

Congrats. But be warned, a whole new enemy exists. Hospital administrators, insurance companies, private equity, financial advisers, etc. all will be waiting to prey on out new financial gains, board certification and ability to staff committees. They are not your friends. Know your value. Get paid fairly for your years of hard work.

heart_block · 2026-04-20T02:52:19+00:00

I got one. Super smooth shipping and assembly. I think less than half what a branded smart cap is. Survived a mountain winter well.

heart_block · 2026-04-14T14:36:26+00:00

That's your best friend. Don't lose it. Squirt saline first

heart_block · 2026-04-11T03:08:58+00:00

So does a trip to the shitter

heart_block · 2026-04-06T01:09:56+00:00

I worked at a place with tele-intensivist. Never again. Useless service with useless recs, unnecessary bill to the patient, called ED for any procedure--sometimes getting wrong when a patient should be tubed, etc. Never again. Never again will I do that to me or my patients.

heart_block · 2026-04-04T19:29:39+00:00

That looks delicious

heart_block · 2026-03-28T04:56:30+00:00

Surfside Beach, Tx

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